- Elevance Health (Tampa, FL)
- …Auditor II is responsible for identifying issues and/or entities that may pose potential risk associated with fraud and abuse. **How you will make an impact:** + ... Examines claims for compliance with relevant billing and processing guidelines...concern. + Recommends possible interventions for loss control and risk avoidance based on the outcome of the investigation.… more
- Elevance Health (Tampa, FL)
- …Auditor II** is responsible for identifying issues and/or entities that may pose potential risk associated with fraud and abuse. **How you will make an impact:** + ... Examines claims for compliance with relevant billing and processing guidelines...concern. + Recommends possible interventions for loss control and risk avoidance based on the outcome of the investigation.… more
- HCA Healthcare (Trinity, FL)
- ….Current Florida licensure as a Registered Nurse preferred _**If serving as facility's primary Risk Manager , VP must have current Florida license in Healthcare ... educational programs for employees, medical staff and board members on analysis of risk assessment, historical and concurrent occurrence and claims data and… more
- HCA Healthcare (Sun City Center, FL)
- …Current Florida licensure as a Registered Nurse preferred _**If serving as facility's primary Risk Manager , VP must have current Florida license in Healthcare ... educational programs for employees, medical staff and board members on analysis of risk assessment, historical and concurrent occurrence and claims data and… more
- Truist (Orlando, FL)
- …following job description:** Under minimal supervision of the Operations Manager , responsible for handling electronic payment exceptions, escalations, and ... related to Wire within established timeframes in order to mitigate risk . ESSENTIAL DUTIES AND RESPONSIBILITIES 1. Independently analyze, research, and process… more
- Marriott (Longboat Key, FL)
- …otherwise negotiating with others. * Implements action plans to monitor and control risk . * Reports any procedure violations to the Director of Loss Prevention and ... and statistical data. * Assists in the management of claims by ensuring proper procedures are followed and documented....* Brings issues to the attention of the department manager and Human Resources as necessary. * Report all… more
- Elevance Health (Tampa, FL)
- …+ Performs in-depth investigations on identified providers as warranted. + Examines claims for compliance with relevant billing and processing guidelines and to ... prevention and control. + Review and conducts analysis of claims and medical records prior to payment. Researches new...concern. + Recommends possible interventions for loss control and risk avoidance based on the outcome of the investigation.… more
- CVS Health (Tallahassee, FL)
- …work with a collaborative, close-knit team on pharmacy and member specific claims data including, but not limited to, financial and operational information ... and the team is highly collaborative. You will report to the Senior Reporting Manager within the Compliance Pharmacy Payments team. To be successful in this role,… more
- IKO (Jacksonville, FL)
- …workers' compensation cases. Acts as facility safety contact for work comp claims questions, interfaces with insurance adjusters, medical professionals and ... to operations and reports directly to the local Plant Manager and functionally to the Director of Health, Safety...(high visibility / floor presence) position. Benefits + Health Insurance (includes teledoc, virtual health, FSA, HCSA & other… more
- Citigroup (Jacksonville, FL)
- …best in class service on Banking and/or Investment inquiries, and ensuring risk is prudently managed. **Responsibilities:** + Fully accountable for servicing and ... trades (Series 7 & 63 required). + Ensures customer claims and complaints are handled in accordance with FINRA...the function in a timely manner. + Appropriately assess risk when business decisions are made, demonstrating particular consideration… more