- Molina Healthcare (Miami, FL)
- …minimal direction, works directly with the Plan's external providers to educate, advocate , and engage as valuable partners, ensuring knowledge of and compliance with ... **Required Experience** + 2 - 3 years customer service, provider service, or claims experience in a managed care setting. + Working familiarity with various managed… more
- Molina Healthcare (FL)
- …with the Plan's highest priority, high volume, strategic providers to educate, advocate and engage as valuable partners. + Requires an in-depth knowledge of ... setting. **Required Experience** + 3 - 5 years customer service, provider service, or claims experience in a managed care setting. + 3-5 years' experience in managed… more
- Monte Nido (Miami, FL)
- …covered by the members benefits and reviewing clinical documentation needed to advocate with our client's insurance most successfully. + Communicate with billing ... regarding billing/ claims issues and status of single case agreements as needed. + Effectively communicate with program leadership, clinicians, and admissions… more
- CVS Health (Tallahassee, FL)
- …and other key personnel. Our TOC Coaches are frontline advocates for members who cannot advocate for themselves. The TOC team will review prior claims to address ... potential impact on current case management and eligibility status. Focus assessments and/or questionnaires are designed to use a holistic approach to identify the need for a referral to clinical resources for assistance in functionality. Additional… more
- Humana (Tallahassee, FL)
- …impacts, and mitigation planning. **Advocacy and Leadership:** + Market Advocacy: Advocate for the market's technical needs and assist in navigating approvals ... processes + Solid understanding of healthcare operations, particularly around claims processing, enrollment, provider data management and clinical operations;… more
- General Motors (FL)
- …issues in a timely manner. They own critical customer interactions and advocate for the customer bridging communications between the Customer Assistance Center, the ... state agencies including supporting Lemon Law processes as well as small claims or other arbitration dispute resolutions. **What You'll Do (Responsibilities)** +… more
- Point32Health (FL)
- …for all lines of business. **Job Description** + Act as a member advocate ; clearly communicating the appeal and grievance process and procedures both orally and ... regulatory requirements + Manage the collection of documents and records (medical, claims , administrative) needed to fully research the appeal or complaint request… more
- Amentum (Cape Canaveral, FL)
- …resources policy and best practices by driving change and serving as a business advocate . + Work closely with the Talent Acquisition and Operations teams to assess ... and conduct E-Verify for new hires. + Manage workers' compensation claims and coordinate follow-up documentation. + Document, process, and maintain records… more
- Walmart (Cocoa, FL)
- …Floor in accordance with Company policies and procedures by properly handling claims and returns, zoning the area, arranging and organizing merchandise, and ... according to company policies and procedures Be a Talent Ambassador Being a brand advocate developing influencing and inspiring others for working in a style that is… more
- Walmart (Cocoa, FL)
- …Floor in accordance with Company policies and procedures by properly handling claims and returns, zoning the area, arranging and organizing merchandise, and ... according to company policies and procedures. + **Be a Talent Ambassador:** Being an advocate for the department and the club by valuing the member's experience in… more