- BrightStar Care (Naples, FL)
- …into a database using this set medical protocol to produce a statement or claim . * Investigate rejected claims , verify this information with the health provider, ... an experienced medical Billing and Payroll Specialist . Responsibilities include weekly processing of billing and payroll.. Managing Authorizations , appeals and re-… more
- Molina Healthcare (Miami, FL)
- …Provides leadership and direction to MMS Operational Units management staff (eg, Claims Processing , Provider Services, Provider Enrollment, Finance, Managed Care ... or equivalent experience **Required Experience** 3 years supervision/management experience in Claims Processing or Provider Services environment and/or any high… more
- Evolent (Tallahassee, FL)
- …: This role works closely with our Evolent partners to support data management, claims processing , and other activities that are within scope. You will work ... and Enrollment/Eligibility to ensure timely and accurate data loads and claims processing occurs. **What You'll Be Doing** : + Maintenance of provider… more
- LogixHealth (Dania Beach, FL)
- …environment and will bring your expertise to process all denied and unpaid claims submitted to insurance carriers to ensure payment is received. The ideal candidate ... A/R (Accounts Receivable) reports to follow up on unpaid claims + Prepare and submit out appeals on ...and billing systems and clearinghouse portals + Prior word processing , spreadsheet, and internet software experience including p roficiency… more
- AdventHealth (Apopka, FL)
- …access and adherence, prepares medications for pharmacist review/check, performs claim adjudication and processes customer (patient) account reconciliation. **The ... drug, medication directions, refills and prescriber are selected + Processes claims adjudication and copay assistance billing for new prescription orders and… more
- Walmart (Orlando, FL)
- …to determine root cause of issues (for example, systems, insurance, stock); processing information for third-party insurance claims ; coordinating with insurance ... with pill cell performance; identifying and properly discarding hazardous waste; processing recalled and expired pharmaceuticals; and disposing or processing … more
- MyFlorida (Panama City, FL)
- …the integrity and confidentiality of data sets under his/her control. Assists in processing both electronic and manual third party claims for personal healthcare ... account within the Health Management System (HMS) and denied claims are researched and resubmitted within 30 days of...Party Liability Company representatives to determine status of unpaid claims . Assists in verifying accounts that may meet the… more
- LogixHealth (Dania Beach, FL)
- …benefits (EOB) statement + Analyze A/R (Accounts Receivable) reports to follow up on unpaid claims + Send out appeals on claims that require an appeal + Submit ... required documentation to insurance companies as requested + Research claims for information in order to process bills in a timely manner + Communicate with… more
- Veterans Affairs, Veterans Health Administration (Gainesville, FL)
- …and collaborates with the assigned Contracting Off icer(s). The Social Worker ensures claims are reviewed and approved in a timely manner. The Supervisory Social ... will not be able to award you credit for the experience/education/training you claim . These are the KSA's for this subject position: Ability to independently… more
- Highmark Health (Tallahassee, FL)
- …analytical and communication skills Preferred + Associate's Degree + 3 years with claims processing and data management + Past auditing and strong ... and ensures compliance with DRG/APC structure and regulatory requirements. Performs periodic claim form reviews to check code transfer accuracy from the abstracting… more