- Molina Healthcare (Orlando, FL)
- …Responsible for accurate and timely auditing of critical information on claims databases. Maintains critical auditing and outcome information. Synchronizes data ... among operational and claims systems and application of business rules as they...processes + Must be able to identify and troubleshoot claim discrepancies by utilizing benefit and provider contracts, regulatory… more
- Cardinal Health (Doral, FL)
- …done. **The Accounts Receivable Specialist II is responsible for processing insurance claims and billing. They will work within the scope of responsibilities as ... and support from AR & Billing leadership teams.** **_Responsibilities_** + Processes claims : investigates insurance claims ; and properly resolves by follow-up &… more
- CVS Health (Tallahassee, FL)
- …and key litigation activities. + Utilizing legal skills to oversee and manage claims against CVS from the initiation of suit through resolution. + Managing all ... identify the litigation strategy in every case assigned. + Creating a plan for claim evaluation to most efficiently resolve or defend cases against CVS while working… more
- Cardinal Health (Tallahassee, FL)
- …and transmitting claims using billing software including electronic and paper claim processing + Following up on unpaid claims within standard billing ... for verifying patient insurance and benefits, preparing and submitting claims to payers, correcting rejected claims , following...and submitting claims to payers, correcting rejected claims , following up on unpaid and denied claims… more
- Molina Healthcare (Tampa, FL)
- …and prepares written response to incoming provider reconsideration request is relating to claims payment and requests for claim adjustments or to requests from ... to ensure that internal and/or regulatory timelines are met. + Research claims appeals and grievances using support systems to determine appeal and grievance… more
- Sedgwick (Miami, FL)
- …& Insurance Adjuster General National **PRIMARY PURPOSE** **:** To handle losses or claims nationally regardless of size, including having the ability to address any ... Account. **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Examines insurance policies, claims , and other records to determine insurance coverage. + Administers… more
- Molina Healthcare (Tampa, FL)
- …accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims databases. Synchronizes ... + Loads and maintain contract, benefit or reference table information into the claim payment system and other applicable systems. + Participates in defect resolution… more
- Molina Healthcare (St. Petersburg, FL)
- …operations, health plan representatives, and other business teams involved in claim processing. Maintains expertise in all forms of reimbursement methodologies ... release notes to accurately request and analyze impact reports of affected claims . + Analyzes, interprets, and maintains configurable tables and files that support… more
- AdventHealth (Tampa, FL)
- …discharged but not final billed as well as ensure we are billing clean claims . The APC Coordinator will assist in the oversight of the outpatient coding queues, ... **ue you'll bring to the team:** Review and analyze claim denials to perform the appropriate resolution, rebilling, and/or...accounts within 72 hours of being routed to the claims edit work queue and coding review needed work… more
- Allied Universal (Miami, FL)
- Company Overview: Advance Your Career in Insurance Claims with Allied Universal(R) Compliance and Investigation Services. Allied Universal(R) Compliance and ... Investigation Services is the premier destination for a career in insurance claim investigation. As a global leader, we provide dynamic opportunities for claim … more