- City of Lakeland (Lakeland, FL)
- …maintaining related files and records, and performing various insurance, claims processing, safety, and loss prevention functions. Work involves processing ... records, reporting risk management statistics, and handling property and casualty claims . This position is responsible for maintaining litigated files and… more
- Sedgwick (Orlando, FL)
- …and professionally with claimants and clients by phone, written correspondence and/or claims system . + Maintains professional client relationships and provides ... based on client plans, state and federal regulations. Ensures that on-going claim management is within company service standards and industry best practices.… more
- Cardinal Health (Tallahassee, FL)
- … claims processing. + Manages billing queue as assigned in the appropriate system . + Manages and resolves complex insurance claims , including appeals and ... in accordance with company policy, regulations, or third-party policy. + More challenging claim cases + Investigates and updates the system with all information… more
- 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
- Northwest Florida Community Hospital (Chipley, FL)
- …functions, capabilities and operation of computer-based billing and patient accounts management systems , including but not limited to CPSI (EHR), Quadax or similar ... and operation of computer-based registration, billing and patient accounts management systems . Requires sufficient knowledge in the use of basic computer software.… more
- Humana (Tallahassee, FL)
- …cost reduction, by increasing the accuracy of provider contract payments in our payer systems , and by ensuring correct claims payment for appropriate CPT/ HCPCS ... cost reduction, by increasing the accuracy of provider contract payments in our payer systems , and by ensuring correct claims payment for appropriate CPT/ HCPCS… more
- USAA (Miami, FL)
- …guidelines and framework, protects USAA and our members from potential fraudulent claims by investigating questionable, suspect claims activity in compliance ... on any questionable or suspect first or third part claims . + Participates in the development of fraud prevention...extract data for analysis from relevant data sources and systems . + Knowledge of city, state and local regulations,… more
- CVS Health (Tampa, FL)
- …will be responsible for designing, developing, and implementing digital solutions and systems . This role requires technical expertise to architect and code software ... applications, perform system testing and debugging, collaborate with cross-functional teams, and...and other IT partners. As part of the AT Claim Organization, you will be responsible for code deliverables… more
- Elevance Health (Lake Mary, FL)
- …data mining, entity review, law enforcement referral, and use of proprietary data and claim systems for review of facility, professional and pharmacy claims . ... to recover corporate and client funds paid on fraudulent claims . **How you will make an impact:** + ...required with understanding of health insurance policies, health insurance claims handling and provider network contracting. + Develops and… more
- Cardinal Health (Tallahassee, FL)
- …Collections, is responsible for the timely follow-up and resolution of insurance claims . This role ensures accurate and efficient collection of outstanding balances ... insurance companies via phone, portals, or email to check claim status, request reprocessing or escalate issues. + Analyze...payment. + Document all collection activities in the billing system according to departmental procedures. + Follow up on… more
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