- 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
- MyFlorida (West Palm Beach, FL)
- STATE VETERANS' SERVICE OFFICER - 50202204 Date: Jan 14, 2026 The State Personnel System is an E-Verify employer. For more information click on our E-Verify Website ... employment history must be verifiable. Please attach any credentials you claim (degrees, certifications, etc.) to your application. MINIMUM QUALIFICATIONS: An… more
- Sedgwick (Jacksonville, FL)
- …equivalent combination of education and experience required. Experience in multi-line claims management processes and system requirements strongly preferred. ... Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance IT Systems Analyst Specialist Sr **PRIMARY PURPOSE OF THE ROLE** : To lead the… more
- Trane Technologies (Panama City, FL)
- …modules. . Assist Engineers and Leaders with developing and improving process systems . . Maintain quality system documentation for processes and procedures. ... Summary Leads Quality Training, managing deviations and oversight of other Quality systems as a Site Admin. Leads internal continuous quality improvement efforts.… more
- Elevance Health (Lake Mary, FL)
- …documentation purposes (eg, letter writing) on lower level auditors. + Identifies new claim types by identifying potential claims outside of the concept where ... environment preferred. + Broad, deep and niche knowledge of medical claims billing/payment systems provider billing guidelines, payer reimbursement policies,… more
- Highmark Health (Tallahassee, FL)
- …inquiries concerning oral, injectable and infusion medication requests, and drug claim edits/prior authorizations. By reviewing member claims history, clearly ... information system . + Enter all authorizations into the Argus IPNS information system to allow claim adjudication. + Complete other assigned duties as… more
- Zelis (FL)
- …Identify new DRG coding concepts to expand the DRG product. + Manage assigned claims and claim report, adhering to client turnaround time, and department ... across our platform of solutions. Zelis sees across the system to identify, optimize, and solve problems holistically with...plan, and policy exclusions. Conduct reviews on inpatient DRG claims as they compare with medical records ICD-10 Official… more
- Mount Sinai Health System (West Palm Beach, FL)
- …:** Mount Sinai Health System is one of the largest academic medical systems in the New York metro area, with more than 48,000 employees working across eight ... **Job Description** **Mount Sinai Health System is currently seeking a full-time Concierge Primary...to be able to answer questions around medical benefits, claims , care coordination and other complexities of the healthcare… more
- Sedgwick (Orlando, FL)
- …time frames, and claims status either by phone, written correspondence and/or claims system . + Reviews medical information to determine if the claimant meets ... and/or client requirements for a qualifying condition. + Makes claim determinations to approve non-complex ADA claims ...Makes claim determinations to approve non-complex ADA claims or makes a recommendation to team lead to… more
- Sedgwick (Orlando, FL)
- …information and claims status either by phone, written correspondence and/or claims system . **QUALIFICATIONS** + Education & Licensing: High school diploma ... naturally empathic and solution-focused. **ESSENTIAL RESPONSIBLITIES MAY INCLUDE** + Makes claim determinations to approve non-complex disability claims or makes… more
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