- Molina Healthcare (Jacksonville, FL)
- …functionality through project inclusion and documentation review to understand proper claims processing for the applicable solution. Validates data received ... support issues related to EDI transaction editing and custom claims processes to determine root cause of issue. Gains...claims to identify billing issues that will impact claims processing and payment. Monitor new solutions implemented to… more
- Molina Healthcare (Jacksonville, FL)
- …Maintains critical provider information on all claims and provider databases. Synchronizes data among multiple claims systems and application of business ... rules as they apply to each database. Validate data to be housed on provider databases and ensure...and best practices while suggesting improvement processes to ensure systems are working more efficiently and improve quality. +… more
- Molina Healthcare (Jacksonville, FL)
- …Maintains critical provider information on all claims and provider databases. Synchronizes data among multiple claims systems and application of business ... rules as they apply to each database. Validate data to be housed on provider databases and ensure...and best practices while suggesting improvement processes to ensure systems are working more efficiently and improve quality. +… more
- Molina Healthcare (Jacksonville, FL)
- …Risk Adjustment Actuarial team. Responsibilities include research, analysis and modeling of complex healthcare claims data , pharmacy data , lab data , and ... **JOB DESCRIPTION** **Job Summary** This Sr . Analyst, Healthcare Analytics role will be responsible...I or Financial/Accounting Analyst I experience desired + Multiple data systems and models + Data… more
- Molina Healthcare (Jacksonville, FL)
- …more affordably. Performs research, financial modeling, and analysis of complex healthcare claims data (medical, pharmacy and ancillary) to deliver practical, ... **Job Description** **Job Summary** Sr . Analyst, Network Strategy, Pricing & Analytics guides...(including trend analysis) by utilizing NetworX Modeler and ETL systems to support negotiating strategies, modeling current and future… more
- Molina Healthcare (Jacksonville, FL)
- … systems to support executive decision-making + Mine and manage information from large data sources + Analyze claims and other data sources to identify ... **JOB DESCRIPTION** **Job Summary** The Senior Analyst, Medical Economics provides support and consultation...reports, and improvement opportunities based on analyses + Provide data driven analytics to Clinical COE, Finance, Claims… more
- Molina Healthcare (Jacksonville, FL)
- … systems to support executive decision-making + Mine and manage information from large data sources. + Analyze claims and other data sources to identify ... **JOB DESCRIPTION** **Job Summary** The Senior Analyst, Medical Economics provides support and consultation...evaluate the impact of provider reimbursement changes + Provide data driven analytics to Finance, Claims , Medical… more
- Molina Healthcare (Jacksonville, FL)
- … claims databases. Maintains critical information on claims databases. Synchronizes data among operational and claims systems and application of ... business rules as they apply to each database. Validate data to be housed on databases and ensure adherence...information into the claim payment system and other applicable systems . + Participates in defect resolution for assigned component… more
- Molina Healthcare (Jacksonville, FL)
- **JOB DESCRIPTION** **Job Summary** Performs research and analysis of complex healthcare claims data , pharmacy data , and lab data regarding network ... + Healthcare Analyst I or Financial/Accounting Analyst I experience desired + Multiple data systems and models + BI tools To all current Molina employees: If you… more
- Bank of America (Jacksonville, FL)
- Fraud Analytics and Innovation Senior Analyst Newark, Delaware;Tampa, Florida; Jacksonville, Florida; Charlotte, North Carolina; Phoenix, Arizona **Job ... customer experience. Key responsibilities include utilizing a variety of systems , such as Excel, SAS, SQL, Tableau, and other...such as Excel, SAS, SQL, Tableau, and other relational data bases, to provide analytical support on strategies, ensure… more
- Walgreens (Jacksonville, FL)
- …by Pharmacy Manager, Staff Pharmacist and Store Manager including utilizing pharmacy systems to enter patient and drug information, ensuring information is entered ... the pharmacist, including those to physicians. Processes (corrects and resubmits) manual claims for third party program prescription services in a timely and… more
- Sedgwick (Jacksonville, FL)
- …and productivity; to provide strategic planning; to assure security and integrity of data systems ; and to manage vendors and evaluate third party and ... to support efficient technology for internal and customer use; serves as a senior management liaison with other departments within and beyond the Systems … more
- Sedgwick (Jacksonville, FL)
- …Attends regular client implementation meetings to gather and interpret critical data necessary for success. + Prepares essential documentation including overpayment ... reports, meeting minutes, and project plans. Provides regular updates to senior management and stakeholders. + Facilitates communication between clients and internal… more
- HD Supply (Jacksonville, FL)
- …account statements. + Performs basic data entry and general research of data within the department systems necessary to update and maintain account ... for follow-up and routes unresolved items to the appropriate departments. + Verifies data entry of account information in multiple systems . Clears and matches… more
- Suddath (Jacksonville, FL)
- …+ Maintains and directs the implementation of procedures to ensure that freight claims are processed and collected in a timely manner. + Forecast, identifies and ... fiscal budgets and ensures effective management within budgetary guidelines. Provides senior management with periodic reports as designated. + Directs staff to… more
- Medtronic (Jacksonville, FL)
- …Clinical Expert + Translates complex technical messaging, dispels competitive claims , resolves complex technical issues, and maintains customer relationships through ... + Practical and demonstrated knowledge of project/program management practices desired for Senior and Principal Levels with the ability to complete work group… more