- Polk County Public Schools (Bartow, FL)
- …consultants in administering the various insurance plans. Develops and supervises loss and claim processing procedures for all types of losses, accidents, and ... consultants in administering the various insurance plans. Develops and supervises loss and claim processing procedures for all types of losses, accidents, and… more
- Sedgwick (Orlando, FL)
- …and federal/state leave of absence eligibility review; and to ensure the ongoing processing of claims . *Spanish or Portuguese speaking a plus* **ESSENTIAL ... and/or client requirements for a qualifying condition. + Makes claim determinations to approve non-complex ADA claims ...Makes claim determinations to approve non-complex ADA claims or makes a recommendation to team lead to… more
- Sedgwick (Orlando, FL)
- …Security Disability Income (SSDI), and other disability offsets; and to ensure the ongoing processing of claims . **ARE YOU AN IDEAL CANDIDATE?** We are looking ... naturally empathic and solution-focused. **ESSENTIAL RESPONSIBLITIES MAY INCLUDE** + Makes claim determinations to approve non-complex disability claims or makes… more
- VetsEZ (FL)
- …care teams, payers, and providers to improve how patients experience care, how claims are processed, and how care coordination is managed across the continuum. By ... we enable smarter decisions, seamless patient engagement, and more efficient claims management. Together, we are shaping a healthcare ecosystem that delivers… more
- Modernizing Medicine (Boca Raton, FL)
- …will focus on advancing intelligent automation across the clinical and healthcare claims data lifecycle. The intern will work with cutting-edge generative AI and ... large language models (LLMs) to derive insights from claim data, evaluate claim states, and support...learning and generative AI models for clinical and healthcare claims data. + Apply LLM and NLP techniques to… more
- Highmark Health (Tallahassee, FL)
- …+ High school diploma or GED + Experience in pharmacy prescription claims processing /submission/payment. **Preferred** + Associate degree + Pharmacy technician ... inquiries concerning oral, injectable and infusion medication requests, and drug claim edits/prior authorizations. By reviewing member claims history, clearly… more
- TEKsystems (Jacksonville, FL)
- …requires a blend of technical acumen, payment accuracy (payment integrity, claims processing ) knowledge, strong problem-solving skills and excellent relationship ... Deep expertise in payment accuracy use cases. Proficiency in claim data processing and data standards (eg,...matter expertise to commercial and customer services teams. Skills claims processing , solutions engineering, data analysis, api,… more
- Cardinal Health (Doral, FL)
- …+ Mails all paper claims . + Acts as a subject matter expert in claims processing . + Manages billing queue as assigned in the appropriate system. + Manages ... getting the right things done. **The Accounts Receivable Specialist is responsible for processing insurance claims and billing. They will work within the scope… more
- Molina Healthcare (Jacksonville, FL)
- …payment methodology & processing is essential + Understanding on hospital claims processing and configuration works + Medicare fee schedule knowledge is ... maintain contract, benefit or reference table information into the claim payment system and other applicable systems. + Participates...**Required Experience** 5-7 years in SQL, Medicare, Networx, QNXT, claims processing and hospital claims … more
- MyFlorida (West Palm Beach, FL)
- …liaison with VA outpatient staff regarding case development and treatment to support claims processing and advocacy issues. Confer with clinic, service center ... employment history must be verifiable. Please attach any credentials you claim (degrees, certifications, etc.) to your application. MINIMUM QUALIFICATIONS: An… more