Pharmacy Billing and Adjudication Specialist Guardian Pharmacy LLCPharmacy Billing and Adjudication SpecialistDaytona, FLWho We Are and What We're About: Our core focus is delivering customized medication management solutions to support healthcare organizations serving seniors and individuals with complex care needs. With our comprehensive suite of tech-enabled pharmacy services and a dedicated team of professionals committed to enriching the lives of those we serve, we are redefining how pharmacy care is delivered.
Health Insurance Claims Adjuster - Medical Claims Adjudication (CMS‑1500/UB‑04) Insurance Administrative Solutions LLCHealth Insurance Claims Adjuster - Medical Claims Adjudication (CMS‑1500/UB‑04)Clearwater, FLAdjusters who handle the potential fraud or waste claims will investigate, track via clear and complete system notes and accurately report on each file/case in a timely manner. Insurance Administrative Solutions, L.L.C. ("IAS"), an Integrity company headquartered in Clearwater, Florida, is a third-party administrator providing business process outsourcing for insurance carriers.
Pharmacy Billing and Adjudication Specialist Guardian Pharmacy Services ManagementPharmacy Billing and Adjudication SpecialistDaytona, FloridaOur core focus is delivering customized medication management solutions to support healthcare organizations serving seniors and individuals with complex care needs. With our comprehensive suite of tech-enabled pharmacy services and a dedicated team of professionals committed to enriching the lives of those we serve, we are redefining how pharmacy care is delivered.
Health Insurance Claims Adjuster - Medical Claims Adjudication (CMS‑1500/UB‑04) Integrity Marketing Group, LLCHealth Insurance Claims Adjuster - Medical Claims Adjudication (CMS‑1500/UB‑04)Clearwater, FLAdjusters who handle the potential fraud or waste claims will investigate, track via clear and complete system notes and accurately report on each file/case in a timely manner. Insurance Administrative Solutions, L.L.C. ("IAS"), an Integrity company headquartered in Clearwater, Florida, is a third-party administrator providing business process outsourcing for insurance carriers.
Immigration Specialist IV AvantImmigration Specialist IVMaitland, FloridaThe Immigration Specialist is expected to exercise discretion and independent judgment with respect to matters of significance, including interpreting and applying immigration laws and regulations, developing policies, and advising management on strategic immigration matters. This role ensures that databases are accurately maintained and that all immigration requirements are current for each applicant, while sustaining timelines and fluid communication with Healthcare Professionals (HCPs) and all Avant Departments.
OPS Medical Disability Case Records Specialist - 64801365 Government of FloridaOPS Medical Disability Case Records Specialist - 64801365ORLANDO, FLReviews medical disability and associated medical documents to determine if additional documentation needed, i.e., Medical Evidence Records (MER) all accounted for to support disability claim, initiates requests for MER (Case receipts, CE requests, claimant/MER source information) received from SSA offices/components/medical vendors or other Disability Determination Services (DDS) offices. This requires the ability to comprehend written and electronic documents including a basic knowledge of medical terminology and comprehension of regulatory policies; ability to make independent case processing decisions' knowledge of the multiple case processing systems (i.e., Social Security Administration (SSA) system (Legacy system), PCOMM and eView); and the skill and ability to review and organize electronic documents.
Claims Quality Business Analyst DOCTORS HEALTHCARE PLANS, INC.Claims Quality Business AnalystCoral Gables, FLFull timeLead implementation of regulatory, benefit, and operational changes affecting RA/EOB content, claims reason codes, remark codes, notices, and member/provider-facing explanations. Position Purpose: The Claims Quality Business Analyst is responsible for analyzing claims operations, payment accuracy, compliance requirements, and quality performance metrics to identify opportunities for operational improvement, regulatory compliance, and member/provider satisfaction.
Manager Subcontracts 1 Northrop Grumman CorpManager Subcontracts 1Melbourne, FL$104,500–$156,700 / yearThe Manager will be responsible for, and act as the main focal point to the Program for all Major Subcontract related activity within their portfolio, escalating issues to Supplier Senior Level management as needed, brief internal executive management and the Customer on the status/issues as it relates to supplier data rights assertions, specially negotiated license rights, commercial item determination, and supporting high visibility terms and conditions or master agreement negotiations. Essential Functions: Responsible for leading a Subcontracts Team, which includes approximately one to three Subcontracts Specialists, who will be responsible for providing and coordinating complex subcontract matters with emphasis on legal, compliance, and subcontract integration for the Subcontract Management Teams (SMTs).
Security Specialist LukosSecurity SpecialistTampa, FloridaTravel: Contractor personnel must support the projected travel in support of government requirements to MARCENT AOR and supporting locations, which includes but not limited to the following countries: Bahrain, United Arab Emirates (UAE), Saudi Arabia, Jordan, Egypt, France, Germany, United Kingdom, Oman, Qatar, Kuwait, Iraq, Israel, Afghanistan, Syria, Lebanon, Yemen, Pakistan, Turkmenistan, Uzbekistan, Kyrgyz Republic, Tajikistan, Kazakhstan, Djibouti, Cyprus, Turkey, Italy, and Greece. Must be able to complete an in-scope (per current DoD 6-year reinvestigation requirement), favorable, ST5 investigation (to include SBPR, PPR, T5R, or current enrollment in the DoD Continuous Evaluation (CE) / Continuous Vetting (CV) program), adjudicated for SCI eligibility by the DoD Central Adjudication Facility (DoD CAF) without conditions, exceptions, or waivers at the time of performance and must maintain the level of security required for the life of the contract.
Cognitive Performance Specialist (50744) Gap Solutions, Inc.Cognitive Performance Specialist (50744)Tyndall AFB, FLParticipate and assist with planning/coordination of enterprise-wide initiatives such as the annual Aircrew Human Performance Summit, cognitive domain qualification course, support distinguished visitor engagements, and contribute to HP-related research as requested by the Program Office. Complete all required CRAFT compliance training and documentation, including CRAFT Program Familiarization, HPO Inappropriate Relationships and Harassment Training and Acknowledgment, DOD/DISA Information Systems Policy, social media Policy, and PII Training.
Consumer Portfolio And Policy Risk Manager I Truist Financial CorporationConsumer Portfolio And Policy Risk Manager IOrlando, FLMonitor problem assets of assigned segments (delinquent loans, non-performing assets and charge-offs) to limit credit losses through regular communication with loss mitigation teams and Default Management. Provide expertise/membership in various key credit functions/committees (Asset Quality meetings, Business Unit Risk Committees, Consumer Credit Working Group, Truist Risk Appetite framework).
Security Specialist Department of the ArmySecurity SpecialistHomestead, FL$113,356–$147,365 / yearSpecialized experience is defined as: 1) Developing security plans and overseeing security inspection schedules; AND 2) Engaging in Information Security (INFOSEC) programs such as, classification, declassification, safeguarding, destruction, and/or disclosure of classified or sensitive information; AND 3) Developing physical measures to safeguard personnel and prevent unauthorized access to equipment, facilities, materials, and/or documents; AND 4) Utilizing investigative scope and regulatory requirements to initiate appropriate security clearances. It is approved by the Assistant Secretary of the Army for Manpower and Reserve Affairs for use in the Army via the following memorandum: Memorandum, Assistant Secretary of Army for Manpower and Reserve Affairs, dated 8 September 2015, subject: Security Professional Education Development (SPeD) Certification Program.
INSTITUTIONAL SECURITY SPECIALIST I - 67072384 DDDP CHATTAHOOCHEE, FL Government of FloridaINSTITUTIONAL SECURITY SPECIALIST I - 67072384 DDDP CHATTAHOOCHEE, FLChattahoochee, FLOfficers will provide and ensure the safety and security of the residents and staff by monitoring the ingress and egress of people, vehicles, and objects within the secure area which may include pat-down searches and observation of Forensic residents outside and inside the Forensic facilities to deter inappropriate actions by routinely making mobile patrols of the institutional campus and surrounding areas, as well as walking patrols throughout the buildings and grounds of the campus. Any person who, after July 1, 1981, pleads guilty or nolo contendere or is guilty of a felony or of a misdemeanor involving perjury or a false statement shall not be eligible for employment or appointment as an officer, notwithstanding suspension of sentence or withholding of adjudication.
Tax Law Specialist Tax Exempt Bond Specialist Department of the Treasury, USTax Law Specialist Tax Exempt Bond SpecialistOrlando, FL$125,776–$192,694 / yearPerforming analytical services related to the structuring of municipal financings including tax advantaged bonds and other financial products beyond traditional tax advantaged bonds including: Short-Term Debt and Cash Flow Management which include Tax Anticipation Notes, Revenue Anticipation Notes, Bond Anticipation Notes, and Commercial Paper. When assigned to the TEB Voluntary Closing Agreement Program, the incumbent confers with customers and representatives to explain financial, legal and other significant issues involved and the applicability of pertinent tax laws, regulations, and related filing requirements and explains corrective actions required or adjustments to promote future compliance.
Security Specialist III: Contractor Special Security Representative (CSSR) (Deploy Only) Sierra Nevada CorpSecurity Specialist III: Contractor Special Security Representative (CSSR) (Deploy Only)FLThe MST team has a long legacy of supporting the Department of Defense, Department of Homeland Security, commercial and international customers with years of experience in platform operations, engineering and full lifecycle management across domains - air, land, sea, space and cyber. Adjudicative factors which affect the outcome of the eligibility determination include, but are not limited to, allegiance to the U.S., foreign influence, foreign preference, criminal conduct, security violations and illegal drug use.