- Healthfirst (FL)
- …problem-solving approaches in producing analyzing and interpreting reports on trending audit finding results and summarizing details to Operations leadership to ... address identified areas for improvement. + Serve as point of escalation for audit disputes. + Conduct comprehensive needs analysis to ensure that audit programs… more
- Molina Healthcare (St. Petersburg, FL)
- …Data Validation) team, assisting in the execution of CMS and internal audit activities. This position contributes to the development of chart retrieval chase ... gain exposure to end-to-end RADV workflows and contribute to meaningful audit readiness efforts. **Knowledge/Skills/Abilities** + Assist with the identification and… more
- Elevance Health (Tampa, FL)
- …unit/brand as appropriate regarding approved interventions such as recovery of overpayment, pre-payment audit of claims or putting providers on notice. + Assists ... + Performs in-depth investigations on identified providers as warranted. + Examines claims for compliance with relevant billing and processing guidelines and to… 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
- Justworks (Tampa, FL)
- Unemployment Claims Associate Tampa, Florida Apply Who We Are At Justworks, you'll enjoy a welcoming and casual environment, great benefits, wellness program ... to you, and you're comfortable using technology to streamline your work. As a Claims Associate on the Unemployment Operations team, you'll play a key role in… 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
- LogixHealth (Dania, FL)
- …issues and appeal if necessary, using software or other resource tools + Prepare audit results and keep department manager current of all findings and audits and ... services, offering a complete range of solutions, including coding and claims management and the latest business intelligence reporting dashboards for clients… more
- Healthfirst (FL)
- …within any area of operations (Member Services, Enrollment & Billing, Claims , Provider Services, etc.). + Experience with database reporting and automation, ... budgeting or internal audit processes. + Experience monitoring quality in a reporting and analysis environment. + Experience conducting root-cause analysis and… more
- USAA (Tampa, FL)
- …and Lean, business operations, risk management, quality assurance and control, or internal audit (in addition to the minimum years of experience required) may be ... substituted in lieu of degree. + 8 years business process execution/knowledge/experience, consulting, and/or process engineering/optimization. + 3 years of direct team lead, supervisory or management experience. + Experience leading and/or participating in… more
- Prestige Employee Administrators (Tampa, FL)
- …+ Communicate with carriers and clients + Collect and maintain plan documentation + Audit plans + Claims assistance + Partner with Accounting to reconcile bill ... + Benefit system set up for new plans + Assist with Open enrollment: + Prepare the system for every client renewal change (benefits and contributions) for Open Enrollment + Update all benefit rules for every client and class for every benefit offered for… more