- Molina Healthcare (FL)
- …concisely, accurately and in accordance with regulatory requirements. * Researches claims processing guidelines, provider contracts, fee schedules and systems ... or equivalent combination of relevant education and experience. * Health claims processing experience, including coordination of benefits (COB), subrogation… more
- Sedgwick (Orlando, FL)
- …federal/state leave of absence eligibility review; and to ensure the ongoing processing of claims . **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Informs ... 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
- 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
- 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 ... done. **The Accounts Receivable Specialist II is responsible for processing insurance claims and billing. They will...company policy, regulations, or third-party policy. + More challenging claim cases + Investigates and updates the system with… more
- Molina Healthcare (Tampa, FL)
- …concisely and accurately, in accordance with regulatory requirements. + Research claims processing guidelines, provider contracts, fee schedules and system ... response to incoming provider reconsideration request is relating to claims payment and requests for claim adjustments...years operational managed care experience (call center, appeals or claims environment). + Health claims processing… more
- Molina Healthcare (Tampa, 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
- Centene Corporation (Tallahassee, FL)
- …Complies with all policies and standards **Education/Experience:** Associate's degree and claims processing , billing and/or coding experience preferred. Three ... updates to key provider groups and model contract + Research and identify any processing inaccuracies in claim payments and route to the appropriate site… more
- Cardinal Health (Doral, FL)
- …GED or equivalent work experience, preferred + Strong knowledge of insurance claim processing and denial management preferred. + Familiarity with Medicare, ... Collector is responsible for the timely follow-up and resolution of insurance claims . This role ensures accurate and efficient collection of outstanding balances… more
- MyFlorida (Alachua, 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
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