- USAA (Tampa, FL)
- …candidate selected for this position will be joining the Service Team within the Claims Actuary and Analytic community, which is part of P&C Data Science. They be ... responsible for delivering insights to the Claims organization related to all things Service to better...The essence of work performed by the Decision Science Analyst involves gathering, manipulating and synthesizing data (eg, attributes,… more
- MetLife (Tampa, FL)
- …Responsibilities: * Conducts quality reviews of Americans with Disabilities Act (ADA) claims . * Identifies trends, root causes, and quality gaps from the analysis ... which to measure quality behaviors. * Assists in the research , analysis, partnering and providing feedback and recommendations for...supported. Required: * 3+ years of experience managing ADA claims . * Experience managing absence claims for… more
- Molina Healthcare (St. Petersburg, FL)
- …trends or discrepancies related to over- or underpayment. + Utilize QNXT to research claims history, provider contract setup, and benefits configuration. + Work ... **Job Description** **Job Summary** We are seeking a highly experienced Lead Analyst , Configuration Oversight to support our Payment Integrity and Claims … more
- Molina Healthcare (St. Petersburg, FL)
- **Job Description** **Job Summary** The Analyst , Reimbursement is responsible for administering complex provider reimbursement methodologies timely and accurately. ... The analyst will support existing lines of business and expansion...Technical Configuration and Configuration Information Management. **Job Duties** + Research , review, and decipher state-specific Medicaid and Medicare reimbursement… more
- Molina Healthcare (St. Petersburg, FL)
- …around Program Valuation on Molina's Risk Adjustment Actuarial team. Responsibilities include research , analysis and modeling of complex healthcare claims data, ... **JOB DESCRIPTION** **Job Summary** This Sr. Analyst , Healthcare Analytics role will be responsible for...provides insights needed to support strategic investment decisions + Research and develop reports and analyses for senior management… more
- Molina Healthcare (St. Petersburg, FL)
- …+ Actively participates in all stages of project development including research , design, programming, testing and implementation to ensures the released product ... technical teams + Appeals & Grievance, healthcare services, or claims background **Preferred License, Certification, Association** Certified Business Analysis… more