- Houston Methodist (FL)
- …medical records to verify and substantiate diagnosis and procedures for charge review, claim edit(s) and/or denied claims and submits clinical appeal or ... physician record and reviews and corrects charge review and claim edit related coding errors in the electronic health...system - one of the nation's leading health systems - the Primary Care Group offers efficient access… more
- Syms Strategic Group, LLC (SSG) (Sarasota, FL)
- …+ Implement continuous improvement methodology through the use of Information Technology (IT) systems or procedures + Maintain inventory of system assets + ... + Strong proficiency in Linux/Unix and Windows operating systems + Experience with system administration tasks...environments Desired experience Electronic Data Interchange X.12 (EDI) Medical Claims + X.12 medical claims (837, 834,… more
- Sedgwick (Tallahassee, FL)
- …of claims including comprehension of medical terminology and substantiating claim decisions. **ADDITIONAL FUNCTIONS and RESPONSIBILITIES** + Acts as a backup for ... Clinical Specialist **PRIMARY PURPOSE** : Performs standard clinical evaluations on claims that require additional review based on medical condition, client… more
- Sedgwick (Tallahassee, FL)
- …Consultant opportunity plays a key role in supporting our general liability claims team. The ideal candidate will bring strong clinical expertise and analytical ... skills to help evaluate medical-related components of claims . Completion of Legal Nurse Consultant certification or coursework...**PRIMARY PURPOSE** **:** To handle complex or high exposure claim issues; to provide medical knowledge of the health… more
- Air National Guard Units (Jacksonville, FL)
- …problems by analyzing installation, circuitry, and operating characteristics of the systems . Adjusts and aligns system sensors, transmitters, amplifiers, power ... technical orders and directives. Accomplishes technical order compliances, modification of components/ systems and completes thorough system checks for proper… more
- University of Miami (Miami, FL)
- …for internal users. + Monitors system availability, working closely with system administrators and business systems analysts. + Recommends changes in ... tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . The UHealth-University of Miami Health System IT Department has an opportunity for a full-time… more
- VetsEZ (FL)
- …models that support secure, interoperable data exchange across care coordination and claims systems . + Translate business and clinical requirements into ... HL7, X12) and data governance in regulated environments; prior experience with claims adjudication, care coordination, or patient engagement systems is highly… more
- Polk County Public Schools (Bartow, FL)
- …in administering the various insurance plans. Develops and supervises loss and claim processing procedures for all types of losses, accidents, and injuries. Reviews ... and audits all policies and invoices for payment of premiums/ claims . Investigates and reviews accidents involving School Board personnel, students, and public.… more
- Molina Healthcare (St. Petersburg, FL)
- …and knowledge to research and resolve claim /encounter issues and pended claims , and updates system (s) as necessary. * Loads and maintains contracts, ... reference table information into the claims payment system and other applicable systems . * Participates in defect resolution for assigned component(s). *… more
- Molina Healthcare (FL)
- …and knowledge to research and resolve claim /encounter issues and pended claims , and updates system (s) as necessary. * Loads and maintains contracts, ... reference table information into the claims payment system and other applicable systems . * Participates in defect resolution for assigned component(s). *… more
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