- Elevance Health (Tampa, FL)
- …**Financial Operations Recovery Specialist** is responsible for setting up and adjusting claims overpayments that have been previously identified. May do all or some ... of the following in relation to cash receipts, cash application, claim audits, collections, overpayment vendor validation, and claim adjustments. **How you will… more
- Cardinal Health (Tallahassee, FL)
- …the integrity and accuracy of revenue cycle operations. By auditing payments, claim history, and beneficiary documentation, this function helps validate claim ... or equivalent work experience, preferred + Knowledge of insurance billing, Medicare claims , and audit processes. + Familiarity with healthcare compliance issues and… more
- Sedgwick (Tallahassee, FL)
- …Insurance Marine Adjuster **PRIMARY PURPOSE** **:** To investigate and process marine claims adjustments for clients; to handle complex losses locally unassisted up ... documentation, and issues settlement. + Receives and reviews new claims and maintains data integrity in the claims...+ Prepares settlement documents and requests payment for the claim and expenses. + Assists in preparing loss experience… more
- Sedgwick (Orlando, FL)
- …Determines objective, quantifiable, medically supported work restrictions for assigned claims . + Facilitates return-to-work (RTW) and accommodation efforts through ... or client directed documentation, notification, or reporting; and documents client contact in claim notes as per Sedgwick CMS standards. + Adheres to medical and… more
- MyFlorida (Bay Pines, FL)
- …FLORIDA DEPARTMENT OF VETERANS' AFFAIRS VA Regional Office - Bureau of Claims Services Bay Pines, Pinellas County Starting Annual Salary: $34,760.18 Paid Bi-Weekly ... employment history must be verifiable. Please attach any credentials you claim (degrees, certifications, etc.) to your application. MINIMUM QUALIFICATIONS: + Must… more
- TEKsystems (Jacksonville, FL)
- …streamline administrative and clinical workflows by enabling eligibility checks, claims processing, prior authorizations, and secure data sharing. These solutions ... a blend of technical acumen, payment accuracy (payment integrity, claims processing) knowledge, strong problem-solving skills and excellent relationship development… more
- CVS Health (Tallahassee, FL)
- …representatives that are responsible for contacting payers to collect on unpaid claims in a timely and accurate manner, researching and resolving payment variances, ... and managing the accurate and timely filing of claims within payer function group. **Additional responsibilities of the... processing changes + Ensure daily reconciliation of electronic claim files + Maintain productivity and quality standards of… more
- Humana (Tallahassee, FL)
- …community and help us put health first** Own and manage Medicaid claims analytics dataset using Databricks. Ensure data accuracy, completeness, and readiness to ... data transformations, automation, and enhancements. Conduct in-depth analysis of healthcare claims to identify data issues and optimization opportunities. Work with… more
- Sedgwick (Tallahassee, FL)
- …of related experience to include two (2) years of workers' compensation or claims related experience and three (3) years of EDI technical experience including ... or equivalent combination of education and experience required. JURIS or claims management application experience preferred. **Skills & Knowledge** + Demonstrates… more
- Sedgwick (Orlando, FL)
- … for multiple lines of business, including but not limited to, expediting the claims process, and providing detailed claim notes on all calls, resolving issues ... for this or other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The… more