- Molina Healthcare (St. Petersburg, FL)
- …and financial outcomes for all PI solutions. + Leads efforts to improve claim payment accuracy, claim referrals, adjustment analysis and financial performance ... Analysis** + Uses a business lens to ensure accurate interpretation of provider claims trends, payment integrity issues, and process gaps. + Applies understanding of… more
- Molina Healthcare (Tampa, FL)
- …and executing operational initiatives tied to Payment Integrity (PI) and provider claims accuracy. The individual will be relied upon to make independent, informed ... SAI targets are met. + Leads efforts to improve claim payment accuracy and financial performance without needing extensive...a business lens to ensure accurate interpretation of provider claims trends, payment integrity issues, and process gaps. +… more
- CenterWell (Sebring, FL)
- …Update HCHB and computer programs as appropriate. . Complete End of Period claim workflow as part of Billing Specialist responsibilities. This includes ... team at the branch to ensure other billing requirements are satisfied to release claims timely. . Adhere to and participate in Agency's mandatory HIPAA / Privacy… more
- Polaris Pharmacy Services, LLC (Fort Lauderdale, FL)
- …Remote Position Type Full Time Job Category Pharmaceutical Description PRIOR AUTHORIZATION SPECIALIST (REMOTE) WHO WE ARE Polaris Pharmacy Services is an industry ... owned with pharmacies. We are proud to offer competitive benefits and industry pay as well as the opportunity...to join the Polaris team. OVERVIEW The Prior Authorization Specialist is responsible for managing and identifying a portfolio… more
- BrightStar Care (Naples, FL)
- …into a database using this set medical protocol to produce a statement or claim . * Investigate rejected claims , verify this information with the health provider, ... We are looking for the an experienced medical Billing and Payroll Specialist . Responsibilities include weekly processing of billing and payroll.. Managing… more
- Elevance Health (Tampa, 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
- L3Harris (Melbourne, FL)
- …Friday off Job Description: We are looking for a labor and employment law specialist to join our centralized Global Labor & Employment practice group, reporting to ... the Senior Director, Managing Counsel - Labor, Employment, Benefits , and Immigration. Essential Functions: + Investigate, negotiate and resolve pre-litigation … more
- The Cigna Group (Miami, FL)
- …specialist to provide exemplary customer and client service of our Cigna products, benefits , and claim processes. As the Dedicated Client Service Partner - ... + Conducts on-site presentations for new hire, active and retiree open enrollment, benefits fair to existing and prospective customers to educate and inform of plan… more
- Mass Markets (FL)
- …satisfaction and retention. + Respond to customer inquiries regarding coverage, benefits , claims , and other insurance-related questions. + Maintain accurate ... We are seeking a Licensed Life and Health Insurance Specialist who will play a vital role in educating...hard work deserves recognition and reward. Our compensation and benefits packages are designed to be competitive and to… more
- MyFlorida (St. Petersburg, FL)
- …rate. + Review statistical reports in Logi. + Assist the Business Operations Specialist in the development and implementation of guidelines to be used for consistent ... application of criteria. + Liaisons with specialist providers requesting additional medical information as needed. INDIRECT...a timely manner. + Enter services and process billing claims . + Enters Services and tracking process for Directions… more