- Trinity Health (Fort Lauderdale, FL)
- …a. Perform coding functions, including CPT, ICD-10 assignment, documentation review and claim denial review b. Responsible for proofing daily charges for accuracy ... and clean claim submission c. Responsible for balancing charges and adjustments...of Ambulatory Payment Classification (APC), and Outpatient Prospective Payment System (OPPS) reimbursement structures and pre-bill edits including Outpatient… more
- Elevance Health (Miami, FL)
- …research and responds to system inquiries and appeals. + Conducts research of claims systems and system edits to identify adjudication issues and to ... eligible for employment based sponsorship. **Ensures accurate adjudication of claims , by translating medical policies, reimbursement policies, and clinical editing… more
- Highmark Health (Tallahassee, FL)
- …business units, coupled with a general understanding of data flows from various corporate systems (eg, claims , billing, lab, and Rx), to solve complex issues and ... applications and consultation on the design, testing, and enhancement of reporting systems . Recommends improvement to plan design + Provides feedback to various… more
- University of Miami (Medley, FL)
- …to report. + Enters, reviews, and retrieves patient account information from system and ensures accuracy. + Submits completed batches to appropriate billing offices ... daily. + Follows up on claims submitted routinely to monitor payment status. + Transmits...information, guarantor and insurance information, place of service, referrals, claim info record, and managed care authorization requirements. +… more
- Sedgwick (Jacksonville, FL)
- …billing data into the system . + Identifies and forwards complex bills to claims examiners. + Codes provider bills in accordance with claims management ... : To code provider bills; to enter pre-coded billing data into the system ; and to verify the output. **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Keys pre-coded… more
- Intermountain Health (Tallahassee, FL)
- …and alignment with charge, coding and charge edits. + Audits and evaluates system automation by comparing the charge/ claim data to the clinical record. ... Leverages other system functionalities to expediate the claim processing for compliant and optimized hospital accounts. + Evaluates, provides education and… more
- Molina Healthcare (Orlando, FL)
- …information on all claims and provider databases. Synchronizes data among multiple claims systems and application of business rules as they apply to each ... * Directs the development, implementation and maintenance of provider data in the claims payment system . * Supports critical business strategies by providing… more
- Akumin (Port St. Lucie, FL)
- …capture, claims management, collections, cash application, denial resolution, and system optimization. The ideal candidate is both a visionary and a tactical ... least 5 years in a senior leadership role. + Deep expertise in billing systems , revenue cycle management tools, and claims processing. + Demonstrated success… more
- AdventHealth (Maitland, FL)
- …in calculating net revenue for AH. Strong ability to mentor and train complex systems to pertinent staff. Responsible for ensuring system builds are audited to ... methodologies and rate component data for government and non-contracted products for system calculation of claims . Facilitates in the completion and coordination… more
- University of Miami (Medley, FL)
- …receipts, and refers accounts to collection agencies. + Processes third-party insurance claims , requests and submits claim forms, and processes insurance ... medical, dental, tuition remission and more. UHealth-University of Miami Health System , South Florida's only university-based health system , provides… more