12 claims analyst jobs at 9 companies in Three Lakes, FL

1w
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Claims Analyst
Sunrise, Florida, United States
$20-$25/hr HybridFull Time
Community Care Plan
Community Care Plan: Florida nonprofit managed care plan serving Medicaid, Florida Healthy Kids, and self-insured employee health plans.
5+ YOEHigh school diploma or GED and 5–7 years of related claims experience required; associate degree and CPC or equivalent preferred. Requires medical claims, coding, reimbursement, audit, and analytical expertise.
ICD-10-CM, HCPCS Level II, HCPCS Level III, CPT, Diagnosis-Related Group (DRG), UB-04, CMS-1500, Standard Operating Procedures (SOPs)
3mo
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Claims & Billing Analyst
Miami, Florida, United States
OnsiteFull Time
Independent Living Systems
Independent Living Systems: Provider of comprehensive managed care and social support services.
2+ YOEBachelor’s degree in Healthcare Administration, Business, Finance, or related field; 2+ years in medical billing/claims; knowledge of billing codes, payer guidelines; proficient with billing software and EHR; strong analytical and communication skills; relevant experience may substitute for education.
Billing software, EHR, Healthcare payer systems
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Claims Quality Business Analyst
Coral Gables, Florida, United States
OnsiteFull Time
Doctors HealthCare Plans
Doctors HealthCare Plans: Florida-based, locally owned Medicare Advantage health plan serving eligible Medicare beneficiaries.
3+ YOEBachelor's degree required with 3–5 years of health plan claims, business analysis, or healthcare analytics experience; requires managed care knowledge, strong reporting, data analysis, communication, and advanced Excel skills.
Microsoft Excel, Facets, QNXT, HealthRules
1d
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Analyst, Claims Research (must reside in Florida)
Florida or Miami or Orlando or Jacksonville or Tampa or St. Petersburg
$20-$39/hr OnsiteFull Time
Molina Healthcare
Molina HealthcareNYSE: MOH: Provider of managed healthcare services for government-sponsored programs.
3+ YOERequires 3+ years of medical claims processing experience or equivalent education and experience, multistate claims knowledge, data analysis, communication, organization, and Microsoft Office proficiency.
Microsoft Office, Microsoft Excel
3mo
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Analyst, Claims Research
Miami, Florida, United States
OnsiteFull Time
Molina Healthcare
Molina HealthcareNYSE: MOH: Provider of managed healthcare services for government-sponsored programs.
3+ YOEAt least 3 years of medical claims processing experience; multi-state exposure; data analysis; strong communication and organizational skills.
Microsoft Excel, Office Suite, Data analysis tools
2w
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Epic Revenue Cycle Professional Billing & Claims Analyst - 6317562
Nashville or Milwaukee or Dallas or Columbus or Kirkland or Cincinnati or New York City or Cleveland or Oklahoma City or Austin or Albany or Chicago or St. Petersburg or Hartford or Pittsburgh or St. Louis or Miami or Sacramento or Raleigh or Minneapolis or Mountain View or Scottsdale or San Francisco or Morristown or Denver or Boston or Philadelphia or Des Moines or Overland Park or Los Angeles or Charlotte or Walnut Creek or Carmel or Seattle or Houston or Arlington or Atlanta or Redmond or Bentonville or Beaverton or Detroit or San Diego
RemoteFull Time, Contract
Accenture
AccentureNYSE: ACN: Global professional services delivering 360° value.
5+ YOERequires 5+ years of work experience, advanced Epic Systems proficiency, active Epic Professional Billing and Claims certification, and a high school diploma or GED.
Epic Systems, Epic Revenue Cycle
1mo
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Senior Application Analyst - Epic Hospital Claims & Remittance - FT - Days - DIO
Miramar, Florida, United States
OnsiteFull Time
Memorial Healthcare System
Memorial Healthcare System: South Florida public health system providing healthcare services.
5+ YOEAssociates in IT or related field, minimum 5 years relevant experience, subject-matter expertise in clinical applications, strong analytical and project management skills, ability to mentor junior staff.
Epic
1mo
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EDI Business Analyst
Miami, Florida, United States
OnsiteFull Time
Pediatrica Health Group
Pediatrica Health Group: Multi-site pediatric primary care organization serving families with children from birth to 18.
5+ YOEDesign and support clearinghouse constructs, monitor EDI feeds, analyze data trends, perform gap/root-cause analysis, and implement process optimizations. Requires deep claims/RCM knowledge and strong communication.
eClinicalWorks, Microsoft Word, Microsoft Excel, Microsoft Outlook, SQL
2mo
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Risk Adjustment Analyst
Doral, Florida, United States
OnsiteFull Time
Centrum Health
Centrum Health: Private primary care provider serving aging and underserved patients through clinics and telehealth in Florida and Texas.
5+ YOEBachelor's degree required; 5+ years SQL development, 3+ years healthcare claims/risk adjustment and analytics, 2+ years Power BI, experience with Python/Scala and Databricks preferred; familiarity with CMS-HCC, HHS-HCC, HEDIS, MSSP.
SQL, Scala, Python, Microsoft Power BI, Databricks, Microsoft Excel
2mo
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Grievance and Appeals Analyst I
Doral, Florida, United States
$22-$24/hr FieldFull Time
Solis Health Plans
Solis Health Plans: Private Florida Medicare Advantage health plan serving Medicare beneficiaries through HMO and dual-eligible coverage.
2+ YOEMinimum 2 years managed care/appeals or equivalent; working knowledge of Medicare/Medicaid/CMS and NCQA; experience with claims/denial management; strong analytical, written and verbal communication; proficiency with Microsoft Office and case/claims systems.
Microsoft Office
1w
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Sr Payment Integrity Analyst
Sunrise, Florida, United States
HybridFull Time
Community Care Plan
Community Care Plan: Florida nonprofit managed care plan serving Medicaid, Florida Healthy Kids, and self-insured employee health plans.
5+ YOEBachelor's degree in healthcare, finance, or related field, or 5+ years relevant experience; 5+ years in health-plan data roles with claims and encounter data; SQL and Power BI proficiency required.
SQL, Microsoft Power BI
1w
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Financial Analyst - Fraud, Waste and Abuse (FWA) (Onsite)
Coral Gables, Florida, United States
OnsiteFull Time
Doctors HealthCare Plans
Doctors HealthCare Plans: Florida-based, locally owned Medicare Advantage health plan serving eligible Medicare beneficiaries.
3+ YOEBachelor's degree and 3 years of healthcare or Medicare Advantage experience required. Requires claims analysis, advanced Excel and SQL, Power BI, dashboard development, communication, and investigative skills.
Microsoft Office, Microsoft Excel, SQL, Power BI