- Guidehouse (Tampa, FL)
- …this position include: + Responsible for the daily resolution of assigned claims with applicable Revenue Integrity pre-bill edits and/or specific Revenue Integrity ... and associated coding modifiers. + Responsible for daily resolution of assigned claims with Revenue Integrity specific denials in the Guidehouse METRIX℠ system. +… more
- Zurich NA (Tallahassee, FL)
- …Qualifications** * Bachelors Degree and 7 or more years of experience in the Claims , Consulting, Risk Engineering or Underwriting area OR * High School Diploma or ... and 9 or more years of experience in the Claims , Consulting, Risk Engineering or Underwriting area OR *...area OR * Zurich Certified Insurance Apprentice, including an Associate Degree and 7 or more years of experience… more
- Humana (Tallahassee, FL)
- …responsible for administering complex Medicaid provider reimbursement methodologies. The associate will support existing Medicaid business and expansion into new ... closely with IT, the pricing software vendor, CIS BSS, Medicaid operations, claims operations, and other business teams involved in the administration of Medicaid… more
- University of Miami (Miami, FL)
- …and other regulatory agency reportable events and prepare submission for approval by Associate Medical Risk management Officer and the Chief Medical Risk Officer. + ... potentially compensable events to Chief Medical Risk Officer, Director of Medical Claims and Assistant General Counsel. + Conduct additional investigation and assist… more
- Zurich NA (Maitland, FL)
- …School Diploma or Equivalent and 14 or more years of experience in the Claims or Underwriting Support areaOR + Zurich Certified Insurance Apprentice including an ... Associate Degree and 5 or more years of experience...and 12 or more years of experience in the Claims or Underwriting Support area + Knowledge of Casualty… more
- Walgreens (Tavares, FL)
- …and maintaining front end and pharmacy asset protection techniques, and filing claims for warehouse and vendor overages (merchandise received, but not billed), ... for non-returnable ABC overstock. Verifies posting of all pharmacy/ prescription claims . + Completes execution of all pricing activities including price changes,… more
- Service Source (Clearwater, FL)
- …of income discrepancies within required timeframes, preparation of special claims , monitoring file accuracy, safeguarding confidentiality, and maintaining organized, ... and submit annual Utility Allowance (UA) schedules. + Oversee special claims related to move-outs. + Monitor condominium-related requirements, including proxy… more
- Allied Universal (New Port Richey, FL)
- Company Overview: Advance Your Career in Insurance Claims with Allied Universal(R) Compliance and Investigation Services. Allied Universal(R) Compliance and ... driving experience** **RESPONSIBILITIES:** + Conduct independent investigations of insurance claims across a range of coverage types, including workers'… more
- CVS Health (Tallahassee, FL)
- …**Provider Advocate** will work within Meritain, primarily with providers and claims . This person oversees various relationships with Meritain's high-profile groups ... reimbursements or settlements. + Attends and participates in daily dedicated Claims Touchpoint calls, specific to addressing complex provider concerns. + Works… more
- Intermountain Health (Tallahassee, FL)
- …documentation requirements, and reimbursement policies, as well as ensures claims meet medical necessity for procedures performed. **Essential Functions** + ... providers for clarification or additional information when needed. + Submits coded claims to billing department or third-party payers in a timely manner. +… more
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