- Molina Healthcare (Jacksonville, FL)
- …Ability to influence across multiple organizational functions - Payment Integrity, Claims , Encounters, Finance, and Actuarial + Proven experience in managing complex ... implement efficient enterprise-wide processes and governance structures that span claims , encounters, clinical, finance and actuarial functions. + Identifies,… more
- Sarasota County Government (Sarasota, FL)
- …North County Program Director and provide coverage for judges during small claims pre-trials, along with other duties as assigned. About the Schedule Work Hours: ... with parties to encourage voluntary participation in mediation. + Facilitate small claims court proceedings and assign volunteers to mediate cases. + Schedule,… more
- Zurich NA (Tallahassee, FL)
- …Diploma or Equivalent and 14 or more years of experience in the Claims or Underwriting Support areaOR + Zurich Certified Insurance Apprentice including an Associate ... including an Associate Degree and 12 or more years of experience in the Claims or Underwriting Support area Preferred Qualifications: + Bachelors degree and 8 or… more
- Select Medical (Gainesville, FL)
- …Screens all incoming correspondence, and, in the absence of the HR Manager/ Director refers materials requiring immediate attention to the appropriate department + ... Pro-actively addresses employee concerns and with the HR Manager or HR Director coordinates any necessary investigations + Processes and maintains all worker's… more
- Cardinal Health (Tallahassee, FL)
- …and proactively provides guidance and trainings on policies. Reporting to the Director , Ethics & Compliance, this position supervises and manages audits to determine ... coders, billers and other appropriate staff. This position will also support the Director with transactional audit diligence and integration planning, as well as the… more
- Molina Healthcare (St. Petersburg, FL)
- …and internal policies and procedures. * Supports the Operational Oversight Manager, Director , and team in the general development of the Operational Oversight ... to demonstrate compliance to regulatory requirements. * Supports Manager and Director with developing the Operational Oversight Work Plan, monitoring and reporting… more
- CVS Health (Tallahassee, FL)
- …for health care service delivery under the direction of nurse or medical director in the most appropriate setting at the most appropriate expense by identifying ... regarding confidentiality. * May assist in the research and resolution of claims payment issues -Supports the administration of the hospital care, case management… more
- Evolent (Tallahassee, FL)
- …Opportunities to work collaboratively with other Utilization Management Leaders including our Director may also be available. **What You Will Be Doing:** + Reviewing ... requesting or submitting prior authorization requests and/or relevant health care experience in claims or appeal & grievances is required. + Ability to read, write… more
- Marriott (Kissimmee, FL)
- …WORK ACTIVITIES** **Managing Security/Loss Prevention Operations** * Assists the Director of Engineering in administering fire prevention programs and emergency ... * Oversees first aid program for guests and employees. * Oversees the claims process and protects company assets by closely monitoring the General Liability and… more
- Monte Nido (Miami, FL)
- …with our client's insurance most successfully. + Communicate with billing regarding billing/ claims issues and status of single case agreements as needed. + ... to peer reviews. + Communicate emerging trends with insurance companies to Director of Utilization Management. + Maintain database of insurance company clinical care… more
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