- Evolent (Tallahassee, FL)
- …Data Analytics & Insights: Lead advanced analyses of healthcare authorization, claims , membership data, and clinical outcomes to uncover cost drivers, utilization ... Serve as a key liaison between analytics, clinical, product, and account management teams to drive alignment, foster collaboration, and deliver high-quality insights… more
- Walgreens (Orlando, FL)
- …pharmacist, including those to physicians. + Processes (corrects and resubmits) manual claims for third party program prescription services in a timely and efficient ... as assigned by the Pharmacy Manager. + Leads Pharmacy Department inventory management activities, such as, ordering, unpacking, checking and storing shipment of… more
- MyFlorida (Ocoee, FL)
- …empowerment, training, and professional development. Through our agency's learning management system, you have access to hundreds of computer-based training ... policies and rules. Responsible for providing legal representation in claims and litigation against and by the Department in...appointment in the Selected Exempt Service (SES) or Senior Management Service (SMS), unless they are registered with the… more
- MyFlorida (Fort Lauderdale, FL)
- …and trial. Responsible for representation in defense of the Department in claims of inverse condemnation, as assigned. The Difference You Will Make: Through ... empowerment, training, and professional development. Through our agency's learning management system, you have access to hundreds of computer-based training… more
- Aston Carter (Medley, FL)
- …with various departments to address queries, manage AR aging, and inform management about collections and outstanding claims status. The role involves ... for accounts. This position requires reviewing and processing invoices and claims , resulting in payment application, credits, denial, and collection of balances.… more
- AdventHealth (Tampa, FL)
- …discharged but not final billed as well as ensure we are billing clean claims . The APC Coordinator will assist in the oversight of the outpatient coding queues, ... promote faster payment. Resolves claim edits within the EPIC management billing system to ensure successful claim submission. Monitor...accounts within 72 hours of being routed to the claims edit work queue and coding review needed work… more
- UIC Government Services and the Bowhead Family of Companies (Orlando, FL)
- …(VISS) program in Orlando, FL. **Responsibilities** * Provides full-time on-site management of the performance of contractual requirements and daily supervision of ... * Minimum of five (5) years of experience in management of Visual Information activities. * Comprehensive knowledge of...characteristics EOE/D/V. In furtherance, pursuant to The Alaska Native Claims Settlement Act 43 USC Sec. 1601 et seq.,… 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 ... Officer on denial decisions. + Resolves escalated complaints regarding Utilization Management and Long-Term Services & Supports issues. + Identifies and reports… more
- Kemper (Tampa, FL)
- … management experience + Extensive knowledge of insurance operations: claims , coverages, products and underwriting is preferable to effectively communicate with ... requirements. + Works directly with strategic partners like Product, Claims , and Operations on issues impacting the account. +...a capable people developer + Should demonstrate excellent time management skills + Must be a logical problem solver… more
- Healthfirst (FL)
- …with internal teams (eg, sales, customer service, compliance) to ensure seamless management of members. + Monitor ,report, and deliver updates on memberships, data ... institution + Leadership experience in a high-volume production billing, enrollment, claims , call center environment or related environment. + Basic understanding of… more