- Prime Therapeutics (Tallahassee, FL)
- …**Job Description** The Claims Analyst is responsible for serving as a Claims Operations subject matter expert on system functionality which may include ... an escalation and mentoring resource on production issues. **Responsibilities** + Represent Claim Operations as subject matter expert (SME) on both internal and… more
- DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
- Position Purpose: The Claims Examiner is responsible for providing expertise and/or claims support in reviewing, researching, investigating, processing and ... adjusting claims and other duties as necessary. Key Responsibilities: +...Ensure that the proper benefits are applied to the claim using the appropriate tools (eg CMS guidelines) +… more
- Centene Corporation (Tallahassee, FL)
- …on workplace flexibility. Florida residents only **Position Purpose:** **With the Sunshine Health Claims Operations team, you will assist with root cause claims ... analysis and root cause resolution. Also, reviewing tickets for claim underpayments.** + Support business initiatives through data analysis, identification of… more
- AssistRx (Orlando, FL)
- …implement and support all operational and financial processes related to claim processing activities. In addition, manager will ensure effective day-to-day ... and external business review meetings. Responsible for forecasts and analyzing claims data to determine Copay utilization, establish escrow account minimum balances… more
- Molina Healthcare (Miami, FL)
- …issues. This role will require actively researching issues to adjudicate claims Requires knowledge of operational areas and systems . ... and investigation/research experience. Outcome focused and knowledge of multiple systems . 1+ years of claims research and/or...knowledge of multiple systems . 1+ years of claims research and/or issue resolution or analysis of reimbursement… more
- CHS (Clearwater, FL)
- **Overview** ** ** ** Claims and Call Auditor (Call Center QC) - Clearwater, FL** ** ** **Summary** The Claims & Call Auditor audits processed medical insurance ... guidelines, performs random medical audits, target audits, re-audits, etc and audits for claims which are in excess of payment authority limits in assigned audit… more
- Ascension Health (Jacksonville, FL)
- **Details** + **Department:** Billing and Claims + **Schedule:** Full-Time, Days Mon. - Fri. 8AM-5PM + **Hospital:** Ascension St. Vincent's + **Location:** 3 ... party payers in an out-patient or medical office environment. + Prepare insurance claims for submission to third party payers and/or responsible parties. + Review … more
- Modernizing Medicine (Tampa, FL)
- …the US, Chile, and Germany. ModMed (https://www.modmed.com/company/) is hiring a driven Patient Claim Specialist who will play a pivotal role in shaping a positive ... all inbound and outbound patient calls regarding patient balance inquiries, claims processing, insurance updates, and payment collections + Initiate outbound calls… more
- Justworks (Tampa, FL)
- Unemployment Claims Associate Tampa, Florida Apply Who We Are At Justworks, you'll enjoy a welcoming and casual environment, great benefits, wellness program ... to prioritize effectively in a fast-paced setting. Learning new systems and tools comes naturally to you, and you're...comfortable using technology to streamline your work. As a Claims Associate on the Unemployment Operations team, you'll play… more
- Insight Global (St. Petersburg, FL)
- …and manage multiple tasks in a fast-paced environment Familiarity with insurance terminology and claims systems is a plus Familiarity with Insurance Claims ... Job Description Insight Global is seeking a detail-oriented and dependable Claims Processor to join our team in Clearwater, FL. This position plays a key… more