- Datavant (Tallahassee, FL)
- …and life experiences to realize our bold vision for healthcare. The Specialist is responsible for identifying, analyzing, and resolving claim denials across the ... proficiency in multiple electronic systems and software tools. The specialist serves as a key liaison between coding, billing,...SSI, Availity, and payer portals. + Submit and track appeals with payers, ensuring all documentation and deadlines are… more
- CVS Health (Tallahassee, FL)
- …**Additional Responsibilities:** Reviews pre-specified claims or claims that exceed specialist adjudication authority or processing expertise. - Applies medical ... written inquiries related to requests for pre-approval/pre-authorization, reconsiderations, or appeals . - Ensures all compliance requirements are satisfied and all… more
- United Therapeutics (Melbourne, FL)
- …which transplant is not currently an option. The Access & Support Specialist provides limited reimbursement support services to healthcare providers and patients in ... to effectively handle questions pertaining to prior authorizations, denials and appeals + Essential telephone and electronic communication skills + Demonstrated… more
- Intermountain Health (Tallahassee, FL)
- …providers, clinical staff, compliance and the CDI team. + Audits and creates appeals for all payer and regulatory denials and downgrades and provides in-depth coding ... review, audit findings, and appeal strategies. + Develops and implements training plans for all internal stakeholders including coders at all levels, providers, clinical staff, compliance and the CDI team. + Audits clinical documentation and coding for complex… more
- MyFlorida (Tallahassee, FL)
- …determinations received from claimants and employers or the Office of RA Appeals and the Reemployment Assistance Appeals Commission. Issues written ... is maintained and available to the Office of RA Appeals for lower level appeals hearings. Required...is an OPS Employment Security Representative II- Employment Review Specialist position in the Department of Commerce's Reemployment Assistance… more
- The Cigna Group (Tallahassee, FL)
- …procedures to routine instructions that require professional knowledge in specialist areas. Provides standard professional advice and creates initial ... Complete onsite quality assessments + Respond to provider inquiries, concerns, complaints, appeals and grievances + Provide ongoing product education to dentists and… more
- Cardinal Health (Doral, FL)
- …skills and prioritizes getting the right things done. **The Accounts Receivable Specialist is responsible for processing insurance claims and billing. They will work ... the appropriate system. + Manages and resolves complex insurance claims, including appeals and denials, to ensure timely and accurate reimbursement. + Processes… more
- Florida Atlantic University (Boca Raton, FL)
- …and Residential Education. Summary of responsibilities: + Process assignments, appeals , cancellations, and assignment change requests for West Campus (first-year ... comments, and complaints. + Serve as the backup to the Office Manager Specialist as it relates to answering phones and assisting with in-person inquiries as… more
- Bristol Myers Squibb (Tampa, FL)
- …for escalation and resolution of Tier 2 queries, plan interpretation and appeals . + Responsible for ensuring internal processes are documented and updated versions ... Workday, ServiceNow, ADP and vendor management. + Certified Employee Benefits Specialist (CEBS) or equivalent Industry designation, preferred. \#LI-Hybrid If you… more
- BrightStar Care (Naples, FL)
- …We are looking for the an experienced medical Billing and Payroll Specialist . Responsibilities include weekly processing of billing and payroll.. Managing ... Authorizations , appeals and re- submission of claims . Posting cash etc. Must be detail oriented and organized . Ability to work in a fast paced environment and can… more