- Molina Healthcare (Orlando, FL)
- …credentialing database necessary for processing of recredentialing applications. * Reviews claims payment systems to determine provider status, as necessary. Ongoing ... Monitoring/Watch Follow-up * Completes follow-up for provider files on 'watch' status, as necessary, following department guidelines and production goals. * Reviews and processes assigned daily alerts for federal/state and license sanctions and exclusions… more
- Molina Healthcare (Tampa, FL)
- …member eligibility and covered benefits, Provider Portal, and status of submitted claims . * Ability to effectively communicate in a professionally setting. **Job ... Qualifications** **REQUIRED EDUCATION** : HS Diploma or equivalent combination of education and experience **REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES** : 1-3 years Sales and/or Customer Service experience in a fast paced, high volume environment… more
- Molina Healthcare (FL)
- …or team leadership experience + 10 years' work experience preferable in claims processing environment and/or healthcare environment + Strong knowledge of SQL ... 2005/2008 SSRS and Power BI report development + Familiar with relational database concepts, and SDLC concepts **Preferred Education** + Masters' Degree in Finance, Economics, Math, Computer Science, Information Systems, or related field. + Preferred… more
- Actalent (Miami, FL)
- …Pharmacy Technician (CPhT). + Experience in pharmacy operations, appeals, managed care, claims processing, and handling denials. + Strong data entry and customer ... service capabilities. + Proficient in computer systems and applications. + Ability to work independently in a remote environment. Additional Skills & Qualifications + National Pharmacy Technician Certification (CPhT) preferred; required for certain supervisory… more
- Amentum (Jacksonville, FL)
- …Expense and Utilization Reports are required the 3rd working day of each quarter. GSA Claims : Each GSA vehicle with any repair over $100 requires a call in with ... diagnosis labor time, parts and labor time for repairs. Required Education / Skills: High School Diploma or equivalent Typing Computer Skills Minimum of 5 years' experience in coordinating fleet operations, vehicle/equipment assignments, repairs, and… more
- CVS Health (Tallahassee, FL)
- …provider issues, benefit questions, care coordination, member eligibility and claims . + Coordinate vendor participation in onsite vaccine administration. Maintain ... provider directories and assist client concerns regarding appropriate care. + Maintain client microsite. Manage member communication strategy by reviewing instructional and marketing materials related to the client's plan. **Required Qualifications** + 2+… more
- Marriott (Clearwater Beach, FL)
- …* Oversees first aid program for guests and employees. * Oversees the claims process and protects company assets by closely monitoring the General Liability and ... Worker's Compensation cases. * Communicates the importance of safety procedures, detailing procedure codes, ensuring employee understanding of safety codes, monitoring processes and procedures related to safety. * Emphasizes teamwork, close working… more
- Molina Healthcare (FL)
- …**I** **E** **N** **C** **E:** + 1 year of Molina experience, health claims experience, OR one year of customer service/provider service experience in a managed ... care or healthcare environment. + Strong verbal and written communication skills. To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive… more
- MyFlorida (Tallahassee, FL)
- …the operations of the Medicaid fiscal agent, including Medicaid claims processing, billing procedures, reimbursement methodologies, and provider enrollment. The ... incumbent in this position shall remain informed about Medicare and other federal and state health care related programs, including other state and national Medicaid-related research and demonstration projects, health care program innovations for special… more
- CVS Health (Tallahassee, FL)
- …members who cannot advocate for themselves. The TOC team will review prior claims to address potential impact on current case management and eligibility status. ... Focus assessments and/or questionnaires are designed to use a holistic approach to identify the need for a referral to clinical resources for assistance in functionality. Additional responsibilities to include but not limited to the following: + Responsible… more