- Point32Health (FL)
- …(https://www.point32health.org/) . **Job Summary** Under the general direction of the Member Appeals and Grievance Supervisor the Appeals and Grievance Analyst ... the professional and compliant management and coordination of assigned member appeals and grievance (complaints) received by Point32Health. This individual works… more
- Cardinal Health (Tallahassee, FL)
- …as assigned in the appropriate system. + Manages and resolves complex insurance claims , including appeals and denials, to ensure timely and accurate ... done. **The Accounts Receivable Specialist II is responsible for processing insurance claims and billing. They will work within the scope of responsibilities as… more
- Molina Healthcare (Jacksonville, FL)
- …+ Provides coordination and processing of pharmacy prior authorization requests and/or appeals . + Explains Point of Sale claims adjudication, state, NCQA, ... member and providers with initiating oral and written coverage determinations and appeals . + Records calls accurately in call tracking system. + Maintains specific… more
- CVS Health (Tallahassee, FL)
- …Provide excellent customer services for high volume inbound provider calls for the Claims Inquiry/ Claims Research Medicaid team. Extensive claims research on ... new claim handoffs, nurse reviews, provider complaints, grievance and appeals via target system. + Assists providers with credentialing/re-credentialing and… more
- MyFlorida (Tallahassee, FL)
- …(relocation benefits are not available for this position) OPS Employment Security Representative II This position will be used for multiple vacancies. OPEN ... issues and the chargeability of employer accounts for benefit payments on claims . This may be accomplished telephonically, through written correspondence, or through… more
- MyFlorida (Fort Lauderdale, FL)
- …(relocation benefits are not available for this position) OPS Employment Security Representative II This position will be used for multiple vacancies. OPEN ... issues and the chargeability of employer accounts for benefit payments on claims . This may be accomplished telephonically, through written correspondence, or through… more
- MyFlorida (Orlando, FL)
- …(relocation benefits are not available for this position) OPS Employment Security Representative II This position will be used for multiple vacancies OPEN ... The Work You Will Do: This is an OPS Employment Security Representative II- Employment Review Specialist position in the Department of Commerce's Reemployment… more
- LogixHealth (Dania Beach, FL)
- …follow-up experience in professional healthcare billing + Familiarity with payer regulations, claims appeals processes, and denial reasons + Proficiency in EHR ... of benefits (EOB) statement + Review A/R (Accounts Receivable) reports to follow up on unpaid claims + Prepare and submit out appeals on claims that require… more
- LogixHealth (Dania Beach, FL)
- …follow-up experience in professional healthcare billing + Familiarity with payer regulations, claims appeals processes, and denial reasons + Proficiency in EHR ... A/R (Accounts Receivable) reports to follow up on unpaid claims + Send out appeals on ...perform each Key Responsibility satisfactorily. The following requirements are representative of the knowledge, skills, and/or ability required to… more
- Highmark Health (Tallahassee, FL)
- …supervisory direction and oversight for all enrollment, premium billing, claims and/or customer service telephone and written correspondence inquiries (routine, ... priority Congressional / Department of Defense), and appeals . Ensures that all processes are compliant with requirements and performance standards are consistently… more