- Canon USA & Affiliates (Tallahassee, FL)
- …and review of collaterals for clinical accuracy and adherence to clinical claims . Effectively interacts with multiple teams including R&D, global and local business, ... expertise, and reviewing study/test-plan design. Influence regulatory specifications and claims strategy by providing clinical consultation during early phase… more
- Molina Healthcare (St. Petersburg, FL)
- …you keep complaint data synchronized across appeals & grievances, enrollment, claims , pharmacy, and quality functions. You surface systemic issues, steer partners ... Mastery * Track record coordinating cross-functional action plans with Enrollment, Claims , Pharmacy, Network, and Member Services * Hands-on experience maintaining… more
- Molina Healthcare (Orlando, FL)
- …and timely validation and maintenance of critical provider information on all claims and provider databases. Staff ensure adherence to business and system ... care experience + Experience in one or more of the following: Claims , Provider Services, Provider Network Operations, Hospital or Physician Billing, or similar.… more
- Elevance Health (Miami, FL)
- …with external accreditation and regulatory requirements, internal policies and claims events requiring adaptation of written response in clear, understandable ... and analyze the grievance and appeal issue(s) and pertinent claims and medical records to either approve or summarize...of 3 years experience working in grievances and appeals, claims , or customer service; or any combination of education… more
- Otsuka America Pharmaceutical Inc. (Tallahassee, FL)
- …third-party data assets, including Xponent Plantrak, DDD, HCOS, Claims Data, Specialty pharma, omnichannel data, SalesForce/Veeva (Call/Sample/Detail), etc. ... 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
- HCA Healthcare (Pensacola, FL)
- …to charitable organizations. Apply Today! **Job Summary and Qualifications** Processes claims electronically to insurance carriers. Mails claims to carriers ... daily/weekly basis. + This applies to all non-transmitted pending claims . + Communicates daily information needed for billing to...action notes and e-mail. + Daily transmits all electronic claims to the billing vendor to be sent directly… more
- Sysco (Auburndale, FL)
- …on injury trends, KPIs, and risk assessments. + Support the workers' compensation claims process by completing OSHA determinations, identifying gaps in claims ... other requirements related to general liability, motor vehicle, and property damage claims . + Partner and collaborate with all functional leaders to influence and… more
- LogixHealth (Dania Beach, FL)
- …Key Responsibilities: + Analyze A/R (Accounts Receivable) reports to follow up on unpaid claims + Assist with trouble shooting with pockets of A/R + Submit required ... documentation to insurance companies as requested + Research claims for information in order to process bills in...+ Correct errors and resubmit all unprocessed or returned claims to insurance companies + Assist in training of… more
- Molina Healthcare (Miami, FL)
- …leadership and direction to MMS Operational Units management staff (eg, Claims Processing, Provider Services, Provider Enrollment, Finance, Managed Care Provider ... equivalent experience **Required Experience** 3 years supervision/management experience in Claims Processing or Provider Services environment and/or any high volume… more
- Zurich NA (Tallahassee, FL)
- …Diploma or equivalent and 10 or more years of experience in the claims or underwriting support areaOR + Zurich approved Apprenticeship program including an associate ... and 8 or more years of experience in the Claims or Underwriting Support area. + Knowledge of Microsoft...and 14 or more years of experience in the Claims or Underwriting Support areaOR + Zurich Certified Insurance… more