- Publix (Lakeland, FL)
- …setting. + In-house experience-preferably in a retail, healthcare, or consumer-facing company . + Familiarity with risk management, claims adjusting, and ... is a corporate counsel role, ideal for someone who has worked within a company 's legal or risk management department, not just representing them from the outside. If… more
- CVS Health (Tallahassee, 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
- Molina Healthcare (Tampa, FL)
- …abuse, and over utilization by providers and recipients. The position will review claims data, medical records, and billing data from all types of healthcare ... Create, edit, and update assigned reports to apprise the company on the team's progress. + Distribute reports to...Medicare programs as well as Marketplace + Understanding of claim billing codes, medical terminology, anatomy, and health care… more
- Elevance Health (Tampa, FL)
- …Cost of Care and/or Provider Contracting organizations. Focuses efforts on lowering claims costs, improving the quality of care, and increasing member and provider ... and specialty care procedures and 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 (Tallahassee, FL)
- …passionate about transforming health care. As the nation's leading health solutions company , we reach millions of Americans through our local presence, digital ... measuring and monitoring the quality and effectiveness of work processes in claim processing and customer service that impact customer satisfaction, medical cost… more
- Elevance Health (Miami, FL)
- …or documentation is unclear. + Trains and educates others on coding documentation, claim payment guidelines, and related issues. + Reviews CPT and ICD-9 codes ... (CPC or CCS-P) required. **Preferred Skills, Capabilities, and Experiences:** + Claims processing experience preferred. + Knowledge of medical terminology and… more
- Siemens Energy (Orlando, FL)
- …with Warranty commercial counterparts in the US & Denmark to better facilitate claim follow up and warranty processes. As the Warranty Controller-NAM, you will be ... close process working with SAP, Manage & Prepare Warranty Claims for various projects on a monthly basis, Maintain...Energy, we are more than just an energy technology company . We meet the growing energy demand across 90+… more
- CVS Health (Tallahassee, FL)
- …passionate about transforming health care. As the nation's leading health solutions company , we reach millions of Americans through our local presence, digital ... met. Ensures resolution of escalated issues related, but not limited to, claims payment, contract interpretation and parameters, or accuracy of provider contract or… more
- Amgen (Miami, FL)
- …access + Investigate access challenges pre and post-infusion to include support for denied claims and claim reviews + Partner with Safety and PV and report ... benefits package, including a Retirement and Savings Plan with generous company contributions, group medical, dental and vision coverage, life and disability… 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