- 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
- Elevance Health (Lake Mary, FL)
- …them against the member/groups benefits. + Updates all of the company's membership system components with investigation results for claim coordination. + Ensures ... provided to assist members enrolling in Medicare. + Reviews claim history to identify claims requiring reconciliation, whether processed or pended, as well as… more
- Travelers Insurance Company (Tallahassee, FL)
- …Imagine loving what you do and where you do it. **Job Category** Claim **Compensation Overview** The annual base salary range provided for this position is ... **What Is the Opportunity?** Lead the strategy and operations of Travelers Claim Medical initiatives focusing on how developments in the broader medical environment… more
- TEKsystems (Jacksonville, FL)
- …or claim investigations. + Escalate unresolved grievances, appeals, or claims to the appropriate department. + Maintain accurate and detailed records of ... healthcare providers with essential questions related to eligibility, benefits, claims , and service authorizations. Your work directly supports individuals… more
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