- Baylor Scott & White Health (Tallahassee, FL)
- …and outbound encounter process. + Monitors and oversees the end-to-end claims encounter management workflow. + Identifies and interprets encounter data, submission ... Performs analysis and reporting activities related to risk score calculation, claims /encounters data submission, chart review programs and audits, and related… more
- Sedgwick (Tallahassee, FL)
- …worker's injury, medical treatment, psychosocial needs, cultural implications and support systems . + Effectively communicates and builds relationships with the ... claims ' examiner, client, injured worker, attorney and supervisor. +...+ Provides recommendations for alternate clinical resources to support claim resolution. + Maintains client's privacy and confidentiality, promotes… more
- Highmark Health (Tallahassee, FL)
- …(ASO); TPA services with an expanded BCI/HNAS offering and management of claims funding and cash management. While identifying and driving process improvements ... in projects and activities that impact the Sales and Operations and claims finance business unit functions. HNAS (Health Now Administrative Services) offers… more
- CDM Smith (Fort Myers, FL)
- …Assist the project team in developing and maintaining a project risk register. Claim management: Early support for claims and disputes on the project. ... Management: The candidate must understand and be knowledgeable in project delivery systems , contracting strategies, and typical contract forms and terms. The role… more
- Veterans Affairs, Veterans Health Administration (Miami, FL)
- …improve patient outcomes. Manages and analyzes risk management data and electronic systems that support incident, reviews, and claims management processes. ... and Patient Safety Service at the Miami VA Healthcare System and are responsible to the assigned rating and...requests. Manages and analyzes risk management data and electronic systems that support incident, reviews, and claims … more
- Zodiac Pool Systems (Orlando, FL)
- …and Fluidra sales managers + Instruct dealers on Fluidra's warranty guidelines and claims processing procedures + Represent Fluidra at local and national trade shows ... and seminars, in conjunction with Fluidra sales and marketing personnel + Work closely with Fluidra sales managers to help promote Fluidra products and services + Up to 75% travel WHAT WE SEEK + 5+ years of industry experience, in addition to significant… more
- MyFlorida (Fort Pierce, FL)
- …procedures (DOHP56-66-18, IOP 56-66, 215.86 FS). Includes billing using Health Management Systems (HMS) System and sliding fee scale. Ensures proper CPT/ICD-10 ... 64084930 1 Date: Sep 23, 2025 The State Personnel System is an E-Verify employer. For more information click...to ensure it was submitted properly and assisting with claim resubmissions. Review patient insurance claims /billing for… more
- Highmark Health (Tallahassee, FL)
- …to resolve issues and provide advice on new programs. Provides guidance to system entities in response to external coding audits conducted by the Medicare ... the ICD-CM, ICD-PCS, CPT and HCPCS Level II code and modifier systems , missed secondary diagnoses and procedures and ensures compliance with DRG/APC structure… more
- Siemens Energy (Orlando, FL)
- …contractual risks, drafting and negotiating agreements, documenting, defending and enforcing claims , and advising and supporting project and site management in the ... to handle multiple projects at the same time and claim management. + Self-driven individual with the ability to...in more than 90 countries, we develop the energy systems of the future, ensuring that the growing energy… more
- Siemens Energy (Orlando, FL)
- …contractual risks, drafting and negotiating agreements, documenting, defending and enforcing claims , and advising and supporting project and site management in the ... able to handle multiple projects atthe same time and claim management. + Self-drivenindividual with the ability to formulate...in more than 90 countries, we develop the energy systems of the future, ensuring that the growing energy… more