- Elevance Health (Altamonte Springs, FL)
- …organizations. **How you will make an impact:** + Focuses efforts on lowering claims costs, improving the quality of care, and increasing member and provider network ... and specialty care procedures. + Recommends policy changes and claim 's system changes to pursue cost savings. + Reviews...Health. Who We Are Elevance Health is a health company dedicated to improving lives and communities - and… more
- CVS Health (FL)
- …passionate about transforming health care. As the nation's leading health solutions company , we reach millions of Americans through our local presence, digital ... Summary** The Negotiator Analyst is responsible for negotiating out-of-network (OON) medical claims valued at $10,000 and above. This role involves learning the… more
- Centene Corporation (Tallahassee, FL)
- …not limited to reimbursement strategy, contracting strategy, unit cost management, claims configuration and network operations. + Oversee network development staff ... opportunities to expand or change the network to meet Company goals. + Manage budgeting and forecasting initiatives for...network costs and provider contracts. + Oversee analysis of claim trend data and/or market information to derive conclusions… more
- CDM Smith (Tampa, FL)
- …applicant-provided cost claims for reasonableness to report to FEMA regarding claim eligibility. Participates in and assists with the development of the final ... to do so. Where it's a priority that the company takes good care of you and your family....your family. Our employees are the heart of our company . As an employer of choice, our goal is… more
- Walmart (Pembroke Pines, FL)
- …associates regarding store operations utilizing technology business initiativesmerchandising and company direction introducing and leading company change efforts ... recruiting and developing qualified associates to meet staffing needs and achieve company growth potential Controls the unexplained loss of merchandise and improves… more
- The Walt Disney Company (Celebration, FL)
- …core functional areas: + Shipment Management + Freight Audit, Allocation, Claims & Payment + OLIVER System Help Desk **Responsibilities:** _Shipment Management:_ ... service expectations. + Manage disposition instructions and oversee the execution of claims filing and collections with supply chain partners, ensuring timely and… more
- Deloitte (Tallahassee, FL)
- …of Health Plan Actuarial liabilities for Incurred But Not Paid (IBNP) claims and Loss Adjustment Expense (LAE) for products covering Medical, Pharmacy, and ... Preferred: * 6+ years of experience working in a consulting or insurance company environment* 2+ years of experience managing teams* Proficient in Microsoft Excel,… more
- Sunrise Senior Living (Coral Gables, FL)
- …internal business controls. + Process and manage unemployment and worker's compensation claims and update claim activity as necessary. + Clearly communicate ... **Business Processes - Key Controls** + Ensure business controls are followed with company policy and completed for each business area. + Assist in providing audit… more
- Insight Global (Jacksonville, FL)
- …protocol by accurately assessing and correcting issues regarding medical necessity, claims denials, bundling issues and charge capture. - Efficiently uses available ... compensation range $25-$35 depending on experience. We are a company committed to creating diverse and inclusive environments where...issues or errors * Ability to analyze and resolve claim denials that are rejected by edits from the… more
- AssistRx (Orlando, FL)
- …+ Submitting billing data to appropriate insurance providers + Processing claims and resolving denial instances + Achieving maximum reimbursement for services ... provided + Completing Medicare and Commercial insurance claim submission. + Documenting and reporting payment information. + Professional level skills in computer… more