- CVS Health (Tallahassee, FL)
- …a Regional Pharmacy Onsite Auditor, you will be an essential part to the Pharmacy Audit Department at CVS/Caremark. In this role, you will be based from your home ... and travel onsite to conduct claims audits at pharmacies throughout multiple states by reviewing...audits at pharmacies throughout multiple states by reviewing prescription claims billed and educating pharmacies on the findings. You… more
- CRC Insurance Services, Inc. (FL)
- …(United States of America) **Please review the following job description:** Process claims , which includes evaluating policy for coverage; working with the insured, ... adjusters, agents and attorneys on the claim and coordinating the payment of claims . In addition, prepare reports such as loss runs and monthly bordereau.… more
- CRC Insurance Services, Inc. (FL)
- …(United States of America) **Please review the following job description:** Process claims , which includes evaluating policy for coverage; working with the insured, ... adjusters, agents and attorneys on the claim and coordinating the payment of claims . In addition, prepare reports such as loss runs and monthly bordereau.… more
- Sherman Associates, Inc. (St. Pete Beach, FL)
- …hotel located in St. Pete Beach, FL, is seeking an experienced Night Audit . With stunning views overlooking the Intercoastal Waterway and Gulf of Mexico, the ... We are currently seeking a part-time and full-time night audit to join our team! Essential Functions + Registers...all Retail transactions for the guest + Issues luggage claims and check guest luggage when requested + Manages… more
- Trustmark (Tallahassee, FL)
- …communities. **About the role** This role is a dedicated training position for Claims that resides in the Knowledge Management & Customer Experience group. The ... primary function of this role is to train and audit new and existing staff in all products including...claim handling process and procedures and experience in handling claims appropriately in accordance with the corporate claim philosophy,… more
- Prime Therapeutics (Tallahassee, FL)
- …combined pharmacy and PBM experience to include:##1 year of work experience in claims processing in an operations, audit or quality assurance environment##1 year ... for recoupment of audits and investigations performed by the Pharmacy Audit Operations and Special Investigations Unit (SIU) teams. **Responsibilities** + Perform… more
- Crowley Maritime Corporation (Jacksonville, FL)
- …and state laws, regulations and plans, including COBRA, HIPPA, FMLA and ADA. Audit employee benefit claims data to ensure billings are processed accurately. ... benefits eligibility and plan offerings. Also help employees resolve eligibility and claims issues. Manage daily benefit transactions to include but not limited to… more
- Humana (Tallahassee, FL)
- …(Medical Coding or Healthcare (Medical Chart Review/Insurance Billing) or Internal/External Audit or Regulatory/Compliance OR Claims Investigations or Criminal ... ensuring appropriateness of billing practices. Prepares complex investigative and audit reports. Understands department, segment, and organizational strategy and… more
- The Hartford (Lake Mary, FL)
- …be determined.* Facilitate gathering and exchange of information with Claims regardingobserved and identified billing issues.* Identify opportunities warranting ... further investigation through discussionwith Claims and law firms, properly escalating observations internally aswell...review of the bill by the field handlerthrough final audit at the appeal level.* Support Claim reorganization and… more
- Elevance Health (FL)
- …and DRGs billed and reimbursed. Specializes in review of Diagnosis Related Group (DRG) paid claims . **How you will make an impact:** + Analyzes and audits claims ... coding principles, clinical guidelines, and objectivity in the performance of medical audit activities. + Draws on advanced ICD-10 coding expertise, mastery of… more
Recent Jobs
-
Medical Assistant Apprentice
- HCA Healthcare (Arden, NC)
-
Services Specialist 9-12 - Centralized Intake Unit - Wayne County
- State of Michigan (Detroit, MI)
-
Academic Orthopedic Surgeon - Foot and Ankle
- Mayo Clinic (Rochester, MN)
-
You'll Be Addicted to Working with Banner University Medical Center Tucson!
- Banner Health (Tucson, AZ)