- Herc Rentals (Bonita Springs, FL)
- …duties such ensuring proper processing of waivers, releases, lien, and bond claims and training and mentoring teams to meet and exceed departmental objectives ... lien releases * Review of compliance standards as requested for internal and external audit * Review of lien rights that have been filed * Responsible for monthly… more
- Humana (Tallahassee, FL)
- …records ensuring appropriateness of billing practices. Prepares complex investigative and audit reports. Decisions are typically related to resources, approach, and ... Bachelor's Degree + Minimum of 3 yrs health insurance claims or Medicare experience + Minimum 3 years of...CPC, CCS, CFE, AHFI) + Understanding of healthcare industry, claims processing and internal investigative process development + Experience… more
- Sedgwick (Jacksonville, FL)
- …**Skills & Knowledge** + Knowledge of TCP/IP services + Knowledge of audit and compliance + Knowledge of vulnerability management + Knowledge of penetration ... for this or other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The… more
- Aston Carter (Medley, FL)
- …+ Reconcile payments and resolve discrepancies and deductions. + Conduct post- audit research and provide detailed analytical reports. + Communicate with retailer ... accounting teams and internal stakeholders. + Process invoices, claims , and apply payments accurately. What We're Looking For + 4+ years of AR/Accounting experience.… more
- Molina Healthcare (Orlando, FL)
- …software and medical record vendors, and other Molina departments, such as Claims , Enrollment, IT etc,. to get appropriate responses and manage contracts and ... + Maximizes use of information from multiple sources, including claims /encounters, pharmacy, utilization management, clinical indicators, industry benchmark, and/or… more
- Molina Healthcare (Jacksonville, FL)
- …+ Responsible for encounters accuracy & completeness (ie, Encounter Production, Audit , Production Vendor Oversight) for assigned lines of business. Responsible for ... Ability to influence across multiple organizational functions - Payment Integrity, Claims , Encounters, Finance, and Actuarial + Proven experience in managing complex… more
- Molina Healthcare (Tampa, FL)
- …of a formal appeal being submitted. + Independently re-evaluates medical claims and associated records by applying advanced clinical knowledge, knowledge of ... the specific programs supported by the plan such as Utilization Review, Medical Claims Review, Long Term Service and Support, or other specific program experience as… more
- Zelis (St. Petersburg, FL)
- …who you are. Position Overview The Manager, DRG Validation of the Expert Claims Review (ECR) department is responsible for daily operations and team management of ... + 5 - 7 years reviewing and/or auditing ICD-10 CM, MS-DRG and APR-DRG claims required + Supervisory experience preferred + Solid understanding of audit … more
- Walgreens (Palm Coast, FL)
- …to further promote productivity. + Ensures the accurate processing of insurance claims to resolve customer issues and prevent payment rejections. Follows-up with ... companies as well as medical providers and participates in 3rd party audit . + Follows-up with medical providers' offices to clarify prescribed medications, dosages,… more
- Walgreens (Vero Beach, FL)
- …Quality Improvement Program. + Ensures the accurate processing of insurance claims to resolve customer issues and prevent payment rejections. Follows-up with ... companies as well as medical providers and conducts or participates in 3rd party audit . + Assists and supports Store Manager and Pharmacy Manager in analyzing and… more