- University of Miami (Miami, FL)
- …to customer inquiries regarding insurance coverage of services and processing of claims . + Follows appropriate procedures to link alternative insurance plan payers ... to the appropriate programs during registration. + Identifies non-contracted HMO payers and refers to proper managing department. + Serves as a lead Insurance Verification Representative and assists in training new staff. + Adheres to University and unit-level… more
- Cardinal Health (Tallahassee, FL)
- …laws and regulations, (eg, Stark, Corporate Practice of Medicine, Anti-Kickback, False Claims Act, and HIPAA); and Marketing and Advertising + Proactively identify ... and assesses business and legal risks + Demonstrate excellent communication skills and ability to provide business clients with clear and precise guidance on business, compliance, and legal risks + Develop and conduct legal training for business clients + Seek… more
- Sumitomo Pharma (Tallahassee, FL)
- …submissions by preparing responses to agency inquiries and contributing to labeling claims . + Review Case Report Forms (CRFs) to ensure data collection aligns ... with protocol-defined analyses. + Develop data presentation plans and design Table, Listing, and Figure (TFL) shells. + Provide guidance to statistical programmers on SDTM/ADaM datasets and TLF specifications. + Perform programming validation for key derived… more
- Molina Healthcare (FL)
- …& ABILITIES** : * 2 - 3 years customer service, provider service, or claims experience in a managed care setting. * Working familiarity with various managed ... healthcare provider compensation methodologies, primarily across Medicaid and Medicare lines of business, including but not limited to, fee-for service, capitation and various forms of risk, ASO, etc. **PREFERRED EDUCATION** : Bachelor's Degree in a related… more
- Cardinal Health (Tallahassee, FL)
- …laws including, Antitrust; healthcare laws and regulations, (eg, Anti-Kickback, False Claims Act, and HIPAA); and Marketing and Advertising + Demonstrate excellent ... communication skills and ability to provide business clients with clear and precise guidance on business, compliance, and legal risks + Develop and conduct legal training for business clients + Understand complex legal, compliance and business situations and… more
- Molina Healthcare (St. Petersburg, FL)
- …rejections. Address a variety of enrollment questions or concerns received via claims , call tracking, or e-mail. Maintain records in the enrollment database. ... **Knowledge/Skills/Abilities** + Has direct oversight of enrollment, premium billing and reconciliation processes and all related staff + Coaches and mentors direct staff, including goal setting and score card development + Monitors and enforces compliance… more
- Meta (Tallahassee, FL)
- …on prescription wearer and channel needs and mindsets 8. Manage prescription product claims , content, and pricing in B2C and B2B contexts, and for wearers with ... and without insurance **Minimum Qualifications:** Minimum Qualifications: 9. 7+ years of experience in product marketing, product management, management consulting, business strategy in vision correction and/or eye health fields 10. In-depth knowledge of… more
- Mass Markets (FL)
- …736), Business Process Management (BPM), Business Process Outsourcing (BPO), Claims Processing, Collections, Customer Experience Provider (CXP), Customer Service, ... Digital Experience Provider (DXP), Account Receivables Management (ARM), Application Software Development, Managed Services, and Technology Services, to mid-market, Federal & enterprise partners. MCI now employs 10,000+ talented individuals with 150+ diverse… more
- Meta (Tallahassee, FL)
- …4. Respond to counterparty inquires and manage contract amendments, collateral, force majeure claims , and other issues as needed 5. Surface and resolve issues in ... ongoing contracts and project operations 6. Track and analyze clean energy operational project performance 7. Track and analyze renewable energy financial project performance 8. Track project progress through development and construction milestones and lead… more
- Three Saints Bay (Panama City, FL)
- …of one of the following disciplines: Military Pay, Military Personnel, Travel Claims , or Navy Transportation. Substitutions for HR background can be from similar ... experience gained in either the private sector or other Federal Agencies. . Ability to obtain and maintain qualifications to access and manage information up to and including the Controlled Unclassified Information (CUI) level. VEVRAA Federal Contractor Three… more