- BrightSpring Health Services (Gainesville, FL)
- …relations with staff and management + Inform operations of worker's compensation claims process. Assist as needed with claim processing. Keep supervisors ... and management team informed of open claims and return-to-work status + Conduct workplace investigations, as...or personal information (Social Security Number, credit card, driver's license , bank information, or payment for work equipment, etc.)… more
- HUB International (Tallahassee, FL)
- …a liaison between the client and insurance carriers for service, enrollment, claims and administration; constantly maintaining quality and service standards as it ... liaison role with insurance company service partner contacts (such service and claim representatives) and client contacts. + Confidentially assist with all claims… more
- Sedgwick (Tallahassee, FL)
- …Insurance Marine Investigator **PRIMARY PURPOSE** **:** To perform detailed admiralty claims investigation and analysis through examination of the loss, collection ... or other stakeholders. + Runs and interprets formal background checks related to claims through online resources, evaluating the results as it relates to policy… more
- Sedgwick (Orlando, FL)
- …work. **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Performs clinical review of referred claims ; documents decision rationale; and completes medical review of all ... claims to ensure information substantiates disability. + Provides clear...preferred. RN, LCSW, LPC, LMHC or CRC required. Current license , registration and/or professional designations as required within 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 ... the Medicaid and Medicare programs as well as Marketplace + Understanding of claim billing codes, medical terminology, anatomy, and health care delivery systems +… more
- Towne Park (Orlando, FL)
- …- 15% Understands and drives business metrics for forecasting, productivity, claims , customer service, and turnover. Ensures all associates accurately identify and ... or equivalent degree preferred **Required Licensure, Certification, etc.:** + Valid driver's license and clean driving record **Work Experience:** + A minimum of one… more
- MyFlorida (Land O' Lakes, FL)
- …employment history must be verifiable. Please attach any credentials you claim (degrees, certifications, etc.) to your application. Other Personnel Technician III ... not limited to job applications, hiring process, disciplinary actions, workers' compensation claims , Family Medical Leave Act (FMLA), new hires and terminations. +… more
- J&J Family of Companies (Jacksonville, FL)
- …(ie, eligibility and benefit verification, pre-authorization, billing, coding, claims , and appeals/grievances); REMs certification; Medicare and Medicaid rules ... monitoring. + Educate staff on payer requirements, coding, billing, claim submission, and acquisition. + Share TC insights with...minimum of a bachelor's degree + A valid driver's license issued in one (1) of the fifty (50)… more
- Highmark Health (Tallahassee, FL)
- …with AHN or other community providers and providing assistance with resolving claim or billing issues.Educate members about access to comprehensiveclinical care and ... department (including but not limited to Product Management, membership, claims , eMarketing, etc.). Identify any opportunities for process improvements.Success will… more
- Centene Corporation (Tallahassee, FL)
- …not limited to reimbursement strategy, contracting strategy, unit cost management, claims configuration and network operations. + Oversee network development staff ... product lines to network costs and provider contracts. + Oversee analysis of claim trend data and/or market information to derive conclusions to support contract… more