Top 100 Programming specialist Jobs in Miami Fl

Healthcare Configuration and Data Integrity Manager
Provider Network Solutions LLC —Miami, FL
- $60,000 - $70,000 a year
- Full-time
- Microsoft Excel
- Microsoft Access
- Microsoft Outlook
Quick Apply
Tech Support Specialist
Optum —Miami, FL
- $20 - $36 an hour
- Full-time
- Microsoft Excel
- Pass drug screening
- Mid-level
DATA SCIENCE CONSULTANT MIAMI
managementsolutions —Miami, FL
- Azure
- Computer literacy
- Finance
Assignment Editor (Spanish)
U.S. Agency for Global Media —Miami, FL
- $113,356 - $147,365 a year
- Weekends as needed
- Background check
- Pass drug screening
- Mid-level
8d
Employee Learning Experience, Senior Specialist NA PRO
Ralph Lauren —Miami, FL
- Full-time
- Organizational skills
- Senior level
- Leadership
HPC Specialist
Florida International University —Miami, FL
- $85,000 - $90,000 a year
- Online Application
- Background check
- Computer Science
- Engineering
- Flexible schedule
Master Control Center Technician
U.S. Agency for Global Media —Miami, FL
- $95,326 - $123,927 a year
- Weekends as needed
- Background check
- Customer service
- Pass drug screening
6d
NOC Specialist
Telx Telecom —Cooper City, FL
- Email
- Customer service
- Mid-level
- Linux
- Health insurance
Clinical Specialist
Saluda Medical —Miami, FL
- Full-time
- Maintenance
- Mid-level
- 3 years
6d
NEW TECHNOLOGIES AND DIGITAL TRANSFORMATION CONSULTANT MIAMI
managementsolutions —Miami, FL
- Entry level
Service Operations Supervisor - Building Automation Systems
Siemens —Miramar, FL
- $68,830 - $117,994 a year
- Full-time
- Sales
- English
- Mid-level
Child Life Activity Assistant (Per Diem, Days)
Nicklaus Children's Hospital —Miami, FL
- Per diem
- Microsoft Excel
- Microsoft Outlook
- Inpatient
Marine Electrician - Yacht Specialist
Gillen Yacht Services, Inc. —Dania, FL
- $35 - $55 an hour
- Full-time
- Clean driving record
- 5 years
- English
- Paid holidays
- Health insurance
Quick Apply
2d
Activities Coordinator-Davie
Kinship Health PACE —Davie, FL
- Full-time
- Spanish
- Experience working with individuals with disabilities
- BLS Certification
- Health insurance
- Dental insurance
Quick Apply
2d
Administration & Grants Specialist
Miami Design Preservation League —Miami, FL
- $65,000 - $75,000 a year
- Weekends as needed
- Background check
- Google Workspace
- Research
- Paid holidays
- Paid time off
Quick Apply
7d
Building Automation Service Specialist
Siemens —Miami, FL
- $42,340 - $72,583 a year
- Extended hours
- 18 years or older
- Microsoft Excel
- Microsoft Outlook
Membership Concierge
Life Time —Miami, FL
- Full-time
- High school diploma or GED
- Bachelor's degree
- 1 year
1d
Account Executive, Miami North
Christian Dior Perfumes —Miami, FL
- $85,000 - $110,000 a year
- Full-time
- 5 years
- Merchandising
- Driver's License
Quick Apply
Health Educator III
Florida International University —Miami, FL
- $52,000 - $55,000 a year
- Weekends as needed
- Research
- Residential
- Master's degree
Enrichment Specialist
OVERTOWN YOUTH CENTER INC —Miami, FL
- Communication skills
- Entry level
Quick Apply

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Healthcare Configuration and Data Integrity Manager

Provider Network Solutions LLC -
Miami, FL

Quick Apply

Job Details

Full-time
$60,000 - $70,000 a year

Qualifications

Computer operation
Microsoft Excel
Microsoft Access
Microsoft Outlook
Medical claims processing
Customer service
Desktop applications
Medical terminology
Master data management

Full Job Description

Description:

Position Summary

The Configuration and Data Integrity Manager is responsible for implementing and interpreting the organization's overall claims, provider configuration, eligibility and provider database management, security, and operations. The Configuration Manager will work with internal departments and external organizations to assure secure data exchanges, integrity, reliability, and availability; plans, organizes and coordinates activities related to the analysis and implementation of network database systems; provides technical guidance and database compliance audits; and consults with business users regarding the use and management of data.

Duties and Responsibilities

Responsible for benefit configuration covered services, copay, deductibles, coinsurance and max out of pocket in TPA system. Ensure mapping and testing behind the scenes and maintain Matrix of Benefit Packages

Responsible for provider records configuration and contract rate load create vendors, practice locations, medical group, networks, reimbursement rate. Collaborate with Provider Relations Department and Credentialing to ensure Responsible for work distribution and resource management of configuration specialist and data integrity specialist.

Configuration support to provider contracts-question if specific agreement received can be entered as noted.
Conduct unit testing to ensure design meets specifications as it relates to product upgrades or new releases.
Responsible for accurately interpreting specific contracts as well as additional business requirements and converting these terms to configuration parameters.
Quality control of all information uploaded in TPA system, i.e., Provider data, fee schedules, network assignment, team member’s responsibilities.
Collaborate with provider call center, clinical and claims department when asked to verify specific provider configuration or benefit configuration information.
Provide system configuration support to organization based on changing business needs.
Review and recommend changes to existing configuration processes.
Analyze and resolve Claims Workflow regarding Benefit & Contract configuration issues in a in with 3 business days.
Provide technical guidance to Data Integrity Specialist in their assigned job duties.
Oversee Configure Medicare/Medicaid/Commercial interest rates in TPA system.
Resolve Eligibility Issues with Health Plans.
Validate reports ran by Data Integrity Specialist on a weekly, monthly, and quarterly basis.
Load and Maintain Fee Schedule in TPA System
Act as liaison between Corporate and the health plan regarding programming development needs related to reporting.

Requirements:

Knowledge

3-5 years of Claims Processing experience required.
1-2 years’ experience in healthcare data management.
Broad knowledge of medical terminology, customer service, claims processing and/or customary and reasonable cost containment, and coordination of benefits and diagnosis coding.

Skills

Advanced knowledge of Microsoft applications: Outlook, access database, excel, word and basic computer navigation.

Quick Apply

Refine Your Search

programming specialist jobs in miami fl

Healthcare Configuration and Data Integrity Manager

Tech Support Specialist

DATA SCIENCE CONSULTANT MIAMI

Assignment Editor (Spanish)

Employee Learning Experience, Senior Specialist NA PRO

HPC Specialist

Master Control Center Technician

NOC Specialist

Clinical Specialist

NEW TECHNOLOGIES AND DIGITAL TRANSFORMATION CONSULTANT MIAMI

Service Operations Supervisor - Building Automation Systems

Child Life Activity Assistant (Per Diem, Days)

Marine Electrician - Yacht Specialist

Activities Coordinator-Davie

Administration & Grants Specialist

Building Automation Service Specialist

Membership Concierge

Account Executive, Miami North

Health Educator III

Enrichment Specialist

I want to receive the latest job alert for programming specialist in miami fl

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