- Highmark Health (Tallahassee, FL)
- …(AHFI) **SKILLS** + Must have knowledge of provider facility payment methodology, claims processing systems and coding and billing proficiency + Must ... have understanding of technical and financial aspects of the health insurance industry + Strong personal computer skills, along with the ability to use fraud/abuse data mining tools are required + Must possess excellent communication skills and be detailed… more
- Prime Therapeutics (Tallahassee, FL)
- …those that may be in use in a Pharmacy Benefit Management setting ( Claims Processing , Prior Authorization, Telephony, Membership, etc.). + Consideration will be ... given as to the candidate's proficiency and ability to contribute in the role based upon the following: + Professional/related publications written and/or contributed to + Contributions to Blogs + Technical certifications such as those offered by SAS, IBM,… more
- Highmark Health (Tallahassee, FL)
- …analytical and communication skills Preferred + Associate's Degree + 3 years with claims processing and data management + Past auditing and strong ... education/training background in coding and reimbursement **_Disclaimer:_** _The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain… more
- CenterWell (Tallahassee, FL)
- …+ Support new business implementations with a goal of ensuring all pharmacy claims are processing appropriately + Drive project development and support project ... management for all product improvement initiatives + Create monthly business reviews and present to client + Escalate issues for immediate review and action whenever necessary + Request, review and approve data used for prioritization purposes + Analyze data… more
- AdventHealth (Altamonte Springs, FL)
- …Team of any coding or coding related issues that adversely impact the claims processing , coding accuracy, and compliance.e. Monitors the queue holds and ... adhere to all hold timelines, releasing on your own accord when appropriate.f. Consistently maintains productivity and accuracy standards as outlined by Coding leadership.g. Review and correct coding on accounts and makes changes as appropriate.1. Demonstrates… more
- Robert Half Accountemps (West Palm Beach, FL)
- …billing software systems and Microsoft Office products. * Experience with electronic claims processing and transmissions. * Comprehensive knowledge of Medicare, ... Medicaid, and commercial insurance billing regulations. * Familiarity with medical terminology and coding standards, including ICD-9 and ICD-10 CM codes. * Strong problem-solving abilities and attention to detail. * Excellent verbal and written communication… more
- AssistRx (Maitland, FL)
- …with medication assistance, prior authorizations, pharmacy benefits investigation, managed care, claims processing . + Experience working with pharmaceutical or ... biotech companies. + 5 years of progressive health care business experience (SPP, hospitals, or insurance). + Computer skills including Microsoft Office Suite Benefits Why Choose AssistRx: + Work Hard, Play Hard: Preloaded PTO: 100 hours (12.5 days) PTO upon… more
- Public Consulting Group (Tallahassee, FL)
- …+ Third Party Administrator Services + Enhance Health and Public Safety Services + Claims Processing Services and Solutions + Consulting and Advisory Services + ... Cost Allocation Plans and Time Studies + Cost Settlement and Supplemental Payment Strategies + Healthcare Access and Markets **Duties and Responsibilities** + Responsible for helping program recipients, family members, and caretakers navigate healthcare… more
- Humana (Tallahassee, FL)
- …make an impact** **Required Qualifications** + Minimum 1 year of experience in medical claims payment and processing + Minimum 1 year of experience analyzing and ... cross functional teams and support analyzing business processes, error processing , issues and ticket creations with the product management...researching medical claims + Proficient in Microsoft Office (Word, Excel, Access,… more
- Highmark Health (Tallahassee, FL)
- …for non-payment, Completing write-offs as appropriate, Coordinating AR issues affecting claims or inquiry processing with Membership and Billing personnel.Lead ... or participate in higher level AR tasks and projects, typically related to: Analysis and reconciliation of cash in transit discrepancies, Streamlining, development and documentation of AR policies or procedures, Reduction of AR balances and coordination of… more