- Molina Healthcare (St. Petersburg, 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
- Cushman & Wakefield (Clearwater, FL)
- **Job Title** Sr . Facilities Manager **Job Description Summary** This position has managerial oversight of multiple facilities, an entire campus, or a portfolio of ... Facilities Manager and/or Assistant Facilities Manager reporting into it. The Senior Facilities Manager has the overall responsibility for overseeing the… more
- Gilead Sciences, Inc. (Tampa, FL)
- …Join Gilead and help create possible, together. **Job Description** As a ** Sr ** **Therapeutic Specialist** you are responsible for representing Gilead's products and ... other team members, and acts as a mentor for junior staff. + Initiates systems to regularly measure sales progress and action plans. Documents and provides feedback… more
- Molina Healthcare (St. Petersburg, 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
- Elevance Health (Tampa, FL)
- …rules. **Preferred Skills, Capabilities, and Experience:** + Experience working with encounter data systems within a healthcare payer or RCM organization and ... **Clinical Documentation and Claims Integrity Director** **Location:** Alternate locations may be...to ensure high quality encounter submissions. + Liaises with senior CareBridge and Elevance Health leadership across Product, Analytics,… more
- CHS (Clearwater, FL)
- …medical necessity and appropriateness, eligibility and coordination of benefits + Documents fully claims referred to senior staff for review and determination + ... **Overview** **Health Insurance Medical Claims Examiner** **(Initial Training On Site - 90...work independently + Knowledge of medical and dental coding systems + Knowledge of medical terminology **Qualifications** **Qualifications:** +… more
- Molina Healthcare (St. Petersburg, 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 (St. Petersburg, 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
- Elevance Health (Tampa, FL)
- … data mining, entity review, law enforcement referral, and use of proprietary data and claim systems for review of facility, professional and pharmacy ... **Investigator Senior ** _Hybrid 1: This role requires associates to...to recover corporate and client funds paid on fraudulent claims . **How you will make an impact:** + Claim… more
- MyFlorida (Tampa, FL)
- OPS - SENIOR CLERK - 36999001 Date: Jul 10, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify Website ... . Requisition No: 847672 Agency: Department of Lottery Working Title: OPS - SENIOR CLERK - 36999001 Pay Plan: Temp Position Number: 36999001 Salary: $17 per… more
- Elevance Health (Tampa, FL)
- … data mining, entity review, law enforcement referral, and use of proprietary data and claim systems for review of facility, professional and pharmacy ... **Investigator Senior ** **Supports the Payment Integrity line of business**...to recover corporate and client funds paid on fraudulent claims . Health insurance experience required with understanding of health… more
- Bank of America (Tampa, FL)
- Fraud Analytics and Innovation Senior Analyst Newark, Delaware;Tampa, Florida; Jacksonville, Florida; Charlotte, North Carolina; Phoenix, Arizona **To proceed with ... must be at least 18 years of age.** Acknowledge (https://ghr.wd1.myworkdayjobs.com/Lateral-US/job/Newark/Fraud-Analytics-and-Innovation- Senior -Analyst\_25019343-2) **Job Description:** At Bank of America, we are… more
- Kemper (Tampa, FL)
- …to achieve growth & profit objectives may include training on products, systems , service, and underwriting, book transfers, development of existing accounts, new ... + Operates as the point of contact for operations, systems and policy training for account products as well...Utilizes agency segmentation, reports and technology to manage account data and performance. + Documents all completed activities with… more
- Molina Healthcare (St. Petersburg, FL)
- …that internal teams and delegated vendors must follow, and you keep complaint data synchronized across appeals & grievances, enrollment, claims , pharmacy, and ... gains, audit readiness, and measurable member-experience improvements. You'll begin as a senior individual contributor with the charter to build a focused CTM… more
- Bank of America (Tampa, FL)
- …expand our capabilities, reduce customer friction, and make strategic investment decisions. Data related to customer profiles and online banking login events hold an ... deliver on organizational loss goals. Device and Non Monetary Fraud and Innovation Senior Analyst- This job is responsible for performing complex analyses of online… more
- Leidos (Tampa, FL)
- …program** as an **Assistant APC** . + Process **450 to 2,800 travel claims per month** , ensuring timely and accurate settlement from initiation to finalization. ... + **5+ years' experience** with **Marine Corps administrative and financial systems , regulations, and procedures** . + Comprehensive understanding of **federal and… more