• DRG Coding Auditor

    Elevance Health (Tampa, FL)
    claim identification, and documentation purposes (eg, letter writing). + Identifies new claim types by identifying potential claims outside of the concept ... or quality assurance environment preferred. + Broad knowledge of medical claims billing/payment systems provider billing guidelines, payer reimbursement… more
    Elevance Health (08/13/25)
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  • Sr VP Medical Director (Hourly)

    Sedgwick (Tallahassee, FL)
    …criteria; to provide leadership within the dedicated team of clinician and claim professionals in support of the dedicated program through training and ... reviews on cases where the nurse is seeking treatment plan clarification, claim denial, disability certification or duration management for return to work guidance.… more
    Sedgwick (08/22/25)
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  • Ops Employment Security Rep II - 1 1 1 1 1 1

    MyFlorida (Tallahassee, FL)
    …initial or additional claims . This is accomplished through tracking the assigned claim load and utilizing the benefit payment system . + Answers inquiries ... relative to the information submitted. Ensures that documentation of claim records is maintained and available to the Office...and policies to determine the eligibility of reemployment assistance claims using the CONNECT system . This includes… more
    MyFlorida (07/23/25)
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  • Ops Employment Security Rep II - 1 1 1 1

    MyFlorida (Orlando, FL)
    …initial or additional claims . This is accomplished through tracking the assigned claim load and utilizing the benefit payment system . + Answers inquiries ... and policies to determine the eligibility of reemployment assistance claims using the CONNECT system . This includes...relative to the information submitted. Ensures that documentation of claim records is maintained and available to the Office… more
    MyFlorida (07/09/25)
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  • HIM Spec

    Community Health Systems (Naples, FL)
    …accuracy and completeness of information in the electronic health record (EHR) system . + Responds to requests for health information, retrieving and releasing ... preparation and submission of patient information for billing, coding, and insurance claim purposes. + Maintains confidentiality and ensures the security of patient… more
    Community Health Systems (08/03/25)
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  • Risk Analyst

    Chewy (Plantation, FL)
    …the team to effectively manage its complex insurance portfolio, oversee claims , maintain regulatory insurance compliance, and scale risk management processes in ... and support accurate renewal data collection for renewal cycles. ** Claims & Reporting** + Collect, review, and report ...updates and communication with the Finance and Accounting teams. ** Systems & Tools** + Serve as the administrator and… more
    Chewy (07/26/25)
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  • Member Grievances Specialist (Medicaid experience)

    Molina Healthcare (Tampa, FL)
    …agencies to ensure that internal and/or regulatory timelines are met. + Research claims appeals and grievances using support systems to determine appeal and ... + Research claims processing guidelines, provider contracts, fee schedules and system configurations to determine root cause of payment error. + Resolves and… more
    Molina Healthcare (09/06/25)
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  • Surveillance Investigator

    Allied Universal (Pensacola, FL)
    Advance Your Career in Insurance Claims with Allied Universal(R) Compliance and Investigation Services. Allied Universal(R) Compliance and Investigation Services is ... the premier destination for a career in insurance claim investigation. As a global leader, we provide dynamic opportunities for claim investigators, SIU… more
    Allied Universal (09/07/25)
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  • Charge Capture Specialist

    BayCare Health System (Tampa, FL)
    …correction of charges, edits, and registration/insurance issues in order to provide clean claims for large volume areas. + Requires attention to detail as well as ... the ability to function in various information system platforms. + Must discuss with provider when discrepancies...individuals at all levels of the organization + Analyze systems and processes and problem solve solutions + Organizational… more
    BayCare Health System (08/03/25)
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  • Facility Coding Inpatient DRG Quality

    Banner Health (FL)
    …coding expertise to resolve issues and support appropriate reimbursement. Proficiency in claims software to address coding edits and claim denials utilizing ... of clinical documentation and correctness of billing codes prior to claim submission; to identify possible opportunities for improvement of clinical documentation… more
    Banner Health (09/06/25)
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