- BrightSpring Health Services (Fort Lauderdale, FL)
- …milligrams) + May resolve issues of denials identified through adjudication, and follow-up claims in Point of Sale (POS) + Maintains current knowledge of Medicaid ... claim regulations and processes + May produce reports and keep management informed of unpaid claims and claims pending follow-up + Provides excellent customer… more
- MetLife (Tampa, FL)
- …Responsibilities: * Conducts quality reviews of Americans with Disabilities Act (ADA) claims . * Identifies trends, root causes, and quality gaps from the analysis ... Coach and mentor ADA Specialists to drive improvements in claim handling. * Provide additional support to the Absence...supported. Required: * 3+ years of experience managing ADA claims . * Experience managing absence claims for… more
- CDM Smith (Fort Myers, FL)
- …Assist the project team in developing and maintaining a project risk register. Claim management: Early support for claims and disputes on the project. ... Identify contractual requirements to maintain and prosecute claims , and assist project team in managing to those...Ensure that proper documentation is developed and maintained for claims . **Job Title:** Commercial Manager - Pacific **Group:** CCI… more
- AdventHealth (Altamonte Springs, FL)
- …Physician Advisor is responsible for providing clinical review of utilization, claims management, and quality assurance related to inpatient care, outpatient ... denial management by reviewing and making recommendations on appealed provider claims and makes determinations for appeals and grievances from patients; assists… more
- TEKsystems (Gainesville, FL)
- …with reusable components they are building * Set of business cases are in claims processing, care space, internally from an enterprise perspective they have a lot of ... processes like a new claim coming in and there are a set of...that need to be executed to decide whether the claim can be processed or not, work with teams… more
- Robert Half Legal (Miami, FL)
- …with focus and precision. * Collaborate with clients to address legal complaints, claims , and defense litigation needs. * Travel within the Southeast region as ... matters, maintaining ethical conduct and confidentiality. * Develop strategies for claim administration and consumer-related legal cases. * Mentor associates at the… more
- LogixHealth (Dania Beach, FL)
- …and route the request to the proper person + Provide patient with their claim balance as requested + Update patient's insurance information in the system and then ... in the system. + Perform daily mailings of letters to patients and HCFA claim forms Qualifications To perform this job successfully, an individual must be able to… more
- LogixHealth (Dania Beach, FL)
- …and route the request to the proper person + Provide patient with their claim balance as requested. + Update patient's insurance information in the system and then ... in the system. + Perform daily mailings of letters to patients and HCFA claim forms Qualifications To perform this job successfully, an individual must be able to… more
- TEKsystems (Coral Gables, FL)
- …Responsibilities * Receives inbound calls and responds to customer requests, inquiries, claims processing inquires, billing or claim disputes. * Handle ... FPLES team, you will be responsible for assisting customer with filing claims , providing detailed explanations of services or products, listening to customers… more
- Humana (Tallahassee, FL)
- …operations for higher quality and operational efficiency. + Ensure enrollment and claims processes comply with regulatory requirements and guidelines. + Partner with ... and regulatory compliance. + Oversee resolution of member enrollment issues, claim disputes, and other reconciliation needs, especially during the Annual Enrollment… more