- Molina Healthcare (Orlando, FL)
- …work on set schedule) Looking for a RN with experience with appeals, claims review, and medical coding. JOB DESCRIPTION Job SummaryProvides support for clinical ... member services review assessment processes. Responsible for verifying that services are medically necessary and align with established clinical guidelines, insurance policies, and regulations - ensuring members reach desired outcomes through integrated… more
- CVS Health (Tallahassee, FL)
- …to assist members in understanding components of the Aetna products including claims , accumulators, usage and balances and cost sharing. Provides support to the ... Department in meeting client expectations regarding efficiency, service levels, privacy maintenance and quality of decision-making. Responsible for maintaining compliance with ERISA, and client specific requirements. Works as part of the team to meet business… more
- 1-800 Water Damage (Miami Gardens, FL)
- …experience, the ability to speak with homeowners and walk them through the claims process for water damage and mold remediation. Make Sales calls daily, follow ... leads when provided and close on leads on their own. We offer a 40K base salary plus Commissions along with paid time off, paid holidays. Company vehicle and expenses are provided, to service North Miami Dade and West Broward areas. This is a great opportunity… more
- CVS Health (Tallahassee, FL)
- …and security requirements. **Required Qualifications** + 1 year minimum of claims processing experience + Experience with system testing and post go-live ... validation + QNXT Experience + Familiarity with clinical and code editing concepts and products (Example: ClaimsXten, Cotiviti PPM & CV) + Extensive knowledge of CPT, HCPCS, ICD-10 coding **Preferred Qualifications** + Prior Relevant Work Experience 3-5 years… more
- ABM Industries (Tampa, FL)
- …coordinates bus evacuation activities as appropriate * Immediately reports any incidents or claims to Operations Manager or Shift Lead * Refuel and maintain shuttle ... equipment and fuel use logs * Maintain a clean work environment, disinfecting shuttle after each use * Performs pre-inspection and post-inspection activities to ensure proper operating conditions, adherence to prescribed Department of Transportation standards,… more
- Carrington (Jacksonville, FL)
- …high degree of accuracy, for all Bankruptcy processes including Acquisitions, Proof of Claims , Notice of Final Cures, Motions for Relief, Agreed Orders, Notices of ... Default and Closings and coordinates corrections as necessary on any Bankruptcy Chapters. + Verify/research borrower payment history and resolves payment posting discrepancies (ie Ledger Balancing) and ensure the company's system of record is updated… more
- Acosta Group (Clearwater, FL)
- …to perform the essential duties. _Responsibilities With Regard to Workers' Compensation Claims :_ You are responsible for reporting all employment related injury you ... incur to your direct supervisor as soon as possible following an incident resulting in an injury. **QUALIFICATIONS** _Education/Experience:_ High school diploma or general education degree (GED); or one to three months' related experience and/or training; or… more
- NBC Universal (Orlando, FL)
- …to Operations, Revenue Operations, third-party vendors, Digital and Technology, Legal/ Claims , Environmental, Health, and Safety. Supports the Managers in each ... of the respective departments by coordinating with UDX stakeholders, third-party service providers, and inter-departmental communications. + Coordinates with Technical Services management for daily staffing requirements, access, and concerns with third-party… more
- Datavant (Tallahassee, FL)
- …fields would be beneficial: Data Entry, Medical Records, Health Care, Insurance Claims Processing and Proof Reading/Editing of Documents + Ability to stay organized ... while working quickly. Strong attention to detail is also required. + Passing annual Introductory HIPAA examination. (Testing to be given annually in accordance with employee review.) + Required to take and pass a 90-day ROI Certification course with a score… more
- Elevance Health (FL)
- …and models data including risk reporting and forecasting. + Calculates monthly claims liability reserves, develops merit rating factors and prepares Department of ... Insurance annual statement exhibits. **Minimum Requirements:** Requires a BA/BS degree and to have passed a minimum of three Society of Actuaries (SOA) or Casualty Actuarial Society (CAS) actuarial exams and a minimum of 1 year related experience; or any… more
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