- CVS Health (Tallahassee, FL)
- …healthcare fraud cases. - Investigates to prevent payment of fraudulent claims committed by insured's, providers, claimants, customer members, etc. - Facilitates ... provide assistance on a timely basis. **Education** - Bachelor's degree and/or an Associate 's degree with three additional years working in health care fraud, waste,… more
- MyFlorida (Tallahassee, FL)
- …casework experience in a program involving adjusting, examining, investigating or processing claims ; 2 years in customer service + Composing letters and tracking ... license program + Interpreting and applying rules, regulations policies and procedures + Associate 's degree or higher in a medical field from an accredited college… more
- Humana (Tallahassee, FL)
- …+ 3 years of clinical RN Experience + Appeals nursing experience + Claims experience + Proficient with Microsoft Office products including Word, Excel and Outlook ... (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart… more
- MyFlorida (Tampa, FL)
- …service. + Independently prepares correspondence, prepares and/or audits travel claims , maintains all administrative records, and other documents as directed. ... PREFERRED QUALIFICATIONS: Preference will be given to candidates with: + An associate 's degree from an accredited college or university. + A bachelor's or… more
- MyFlorida (Fort Lauderdale, FL)
- …Travel Preferred: + Bachelor's Degree from an accredited college or university;OR + Associate 's Degree from an accredited college + Bilingual in both English and ... established an email where people can electronically file claims or ask questions. The email is ###@fdva.state.fl.us.… more
- Antech Diagnostics (Orlando, FL)
- …according to established SOPs and reflect current manufacturing processes and label claims . + Work under close to moderate supervision with limited latitude for ... do not have a written search agreement or position-specific requisition submitted to any Associate of Antech will be deemed the sole property of Antech and no fee… more
- Humana (Tallahassee, FL)
- …Pharmacy Solutions ensuring compliance with programmatic requirements, such as claims processing, prior authorization, formulary management and clinical programming ... (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart… more
- Point32Health (FL)
- …regulatory requirements + Manage the collection of documents and records (medical, claims , administrative) needed to fully research the appeal or complaint request ... perform the job** **Certification and Licensure** **Education** + Required (minimum): Associate 's Degree or equivalent experience in health care, conflict resolution… more
- Humana (Tallahassee, FL)
- …2 years of Humana Experience + Knowledge of Humana Medical and Pharmacy Claims Processing Systems + Experience with data query/data programming applications (ie SQL, ... (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart… more
- MyFlorida (Tampa, FL)
- …insurance policies or claims or providing customer service. + OR an associate 's degree or higher from an accredited college or university can substitute for the ... work experience. + OR 60 semester hours or 90 quarter hours can substitute for the experience. + Two years or more of supervisory experience leading a diverse team. + Must be willing to travel. PREFERENCES + Experience with process improvement, performance… more