- Cardinal Health (Tallahassee, FL)
- …as required, necessary, or appropriate. + Acts as a subject matter expert in claims processing . + Processes claims : investigates insurance claims ; ... administration customer and vendor pricing, rebates, billing (including drop-ships), processing chargebacks and vendor invoices and developing and negotiating… more
- MyFlorida (Tallahassee, FL)
- …workers' compensation specialists with reviewing and evaluating medical-only workers' compensation claims , processing and paying medical and legal bills ... COMPENSATION EXAMINER DIVISION: RISK MANAGEMENT BUREAU: STATE EMPLOYEE WORKERS' COMPENSATION CLAIMS CITY: TALLAHASSEE COUNTY: LEON SPECIAL NOTES: Preferences: + Two… more
- Molina Healthcare (Tampa, FL)
- …is likely to be made, to ensure medical necessity and appropriate/accurate billing and claims processing . + Reevaluates medical claims and associated records ... Duties** + Facilitates clinical/medical reviews of retrospective medical claim reviews, medical claims and previously denied cases in which an appeal has been made,… more
- Prime Therapeutics (Tallahassee, FL)
- …analysis to include 1 year of experience in Pharmacy Benefit Management (PBM), claims processing , healthcare, and/or related field + Must be eligible to ... analysis of Prime's financial pricing programs, including data extraction, storage, manipulation, processing and analysis + Analyze claims data of varying… more
- Molina Healthcare (FL)
- …years of experience working in the group health business preferred, particularly within claims processing or operations. + A demonstrated working knowledge of ... etc.) + Experience with UNET, Comet, Macess/CSP, or other similar claims processing systems. + Demonstrated ability to use MS Excel/Access platforms working… more
- CVS Health (Tallahassee, FL)
- …key payers to discuss reimbursement issues and payer publication notices affecting claims processing changes + Ensure daily reconciliation of electronic claim ... are responsible for contacting payers to collect on unpaid claims in a timely and accurate manner, researching and...variances, and managing the accurate and timely filing of claims within payer function group. **Additional responsibilities of the… more
- Humana (Tallahassee, FL)
- …certification from the AAPC and/or AHIMA) + Extensive knowledge of medical claims processing and familiarity with reimbursement methodologies, ICD, CPT, and ... Medical Coverage Policies and Claims Payment Policies + CAS claims processing experience + Experience in data analysis and trend monitoring **Work-At-Home… more
- Mass Markets (Tampa, FL)
- …736), Business Process Management (BPM), Business Process Outsourcing (BPO), Claims Processing , Collections, Customer Experience Provider (CXP), Customer ... support inbound customer service, help desk, technical support, and back-office processing representatives for commercial and public sector support positions. In… more
- ICW Group (Orlando, FL)
- …injured workers. + Communicates with insureds to obtain information necessary for processing claims . + Contacts and/or interviews injured workers, doctors, ... and employers to get additional information. + Communicates claim activity and processing with the injured worker and insured. + Maintains professional client… more
- MyFlorida (Tallahassee, FL)
- …computing with emphasis in data processing , financial accounting, draw games, claims processing and prize payment, and website. + Knowledge of concepts, ... on bids. + Assists in the establishment of information processing standards for the Florida Lottery. + Assists in...the latest technology, trends, and developments in the data processing industry as they relate to the Florida Lottery's… more