- Arlington Toyota (Jacksonville, FL)
- …clarify discrepancies, and provide any additional information needed to approve claims . * Customer Communication: Explain estimates, repair options, and the ... claims process to customers in a clear and empathetic...of experience in collision estimating, automotive repair, or insurance claims , preferably in an auto body shop or insurance… more
- Otsuka America Pharmaceutical Inc. (Tallahassee, FL)
- …and their staff on matters related to access, coverage, reimbursement processes, claims submissions, and coding requirements + Analyze payer criteria and provide ... you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to...legitimate job opportunity. Scammers may also send offers or claims from a fake email address or from Yahoo,… more
- Sedgwick (Jacksonville, FL)
- …combination of education and experience required to include two (2) years of claims management, managed care or other related experience. **Skills & Knowledge** + In ... depth knowledge of claims management, managed care and/or absence management processes and...other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating… more
- USAA (Tampa, FL)
- …trials, and mediations. + Provides legal advice to clients and P&C Claims team members. Develops, and implements legal strategy and ongoing budget projections ... to Claims Litigation, and clients, as appropriate on assigned cases....for trial. + Provides training to support staff, P&C Claims and Claims Litigation regarding changes in… more
- MyFlorida (Tallahassee, FL)
- …provided to division staff during oversight reviews to justify costs, expenditures, claims for reimbursement or requests for payment. Gathers, organizes and analyzes ... indirect costs is occurring unless an agreement is in place. Analyzes claims and payment requests against federal cost principles and program regulatory… more
- CVS Health (Plantation, FL)
- …in-person support across multiple worksites, handling complex benefit and claims inquiries, and providing education during open enrollment and health-related ... and Resolve:** Handle member inquiries and escalations related to benefits, claims , eligibility, and policy interpretation by identifying root causes, coordinating… more
- Elevance Health (FL)
- …and DRGs billed and reimbursed. Specializes in review of Diagnosis Related Group (DRG) paid claims . **How you will make an impact:** + Analyzes and audits claims ... applicable state(s). + Requires a minimum of 10 years of experience in claims auditing, quality assurance, or clinical documentation improvement, and a minimum of 5… more
- Highmark Health (Tallahassee, FL)
- …supervisory direction and oversight for all enrollment, premium billing, claims and/or customer service telephone and written correspondence inquiries (routine, ... problems. Provides research and technical support need to address complex claims and inquiries and/or when systems problems occur. Provides direction for… more
- Intermountain Health (Tallahassee, FL)
- …**Essential Functions** + Oversees the day-to-day revenue cycle functions including claims processing, denials, payments, customer service, and follow up on ... contractual arrangements affecting payments, to research incomplete, incorrect or outstanding claims and/or patient issues. Investigates and resolves claims … more
- MyFlorida (Tallahassee, FL)
- …design and implement algorithms to effectively data-mine within various types of claims data utilizing a variety of software applications; compile research, data ... limited to, the following: * Identify suspicious patterns in claims data and other sources by applying your knowledge...a variety of sources, including but not limited to claims platforms, data warehouse and other applicable databases within… more