- University of Miami (Miami, FL)
- …is highly desirable. + Minimum 3 years of relevant experience + Resolute Professional Billing Claims and Electronic Remittance Administration required + ... + Define Business Intelligence requirements jointly working with management and professional staff in user departments. Technical solutions must satisfy the business… more
- AdventHealth (Maitland, FL)
- … processing, contract management, or medical economics experience Proficiency in understanding professional and facility claims and managed care concepts such as ... sources using knowledge of healthcare managed care contracts and healthcare administrative claims data Reviews existing complex models and implements them on new… more
- Brunswick (Stuart, FL)
- …+ Experience processing replacement orders + Prior Experience with warranty policies, claims and processing + Professional poise and presence with excellent ... communication skills (writing, speaking, and telephone) Preferred Qualifications + ABYC, NMEA, or MEI Certification + FCC RADAR Endorsement + Bilingual in Spanish and English Working Conditions: + Hybrid office schedule and environment + Travel up to 10% of… more
- Evolent (Tallahassee, FL)
- …focus (health administration, epidemiology, public health, biology) + 1+ years of professional experience in claims -based healthcare analytics with a payer, ... CPT Codes, RVUs, bundled payments, etc. + Working knowledge of healthcare claims ; specifically, differences between institutional vs professional billing and… more
- AdventHealth (Maitland, FL)
- … claims processing, contract management, or medical economics Proficiency in understanding professional and facility claims and managed care concepts such as ... various sources using knowledge of healthcare managed care contracts and administrative claims data. + Employs existing complex models and implements them on new… more
- HCA Healthcare (Kissimmee, FL)
- …to Quality of Care Concerns. 7. Investigates incidents that could lead to professional /general liability claims ; makes adjustments to patient accounts as needed ... and Qualifications** **POSITION SUMMARY: Responsibilities include risk/CMS data management, claims management, education components of the facility's risk management… more
- Allied Universal (Jacksonville, FL)
- …Law Associate (FCLA) + Fraud Claim Law Specialist (FCLS) + Certified Protection Professional (CPP) + Associate in Claims (AIC) + Chartered Property Casualty ... Company Overview: Advance Your Career in Insurance Claims with Allied Universal(R) Compliance and Investigation Services. Allied Universal(R) Compliance and… more
- Highmark Health (Tallahassee, FL)
- …SUMMARY** This job requires the ability to identify issues related to professional and facility provider claims data including determining appropriateness of ... of effective Payment Integrity strategies on a pre-payment and retrospective claims review basis. Review process includes a review of medical documentation,… more
- Sedgwick (Jacksonville, FL)
- …Fortune Best Workplaces in Financial Services & Insurance Bill Review Analyst | Professional Liability | Remote **PRIMARY PURPOSE** : The Bill Review Analyst plays a ... critical role in supporting the medical malpractice claims team by ensuring legal invoice accuracy, compliance, and defensibility. This position is responsible for… more
- Humana (Tallahassee, FL)
- …caring community and help us put health first** The Senior Payment Integrity Professional uses technology and data mining, detects anomalies in data to identify and ... collect overpayment of claims . Contributes to the investigations of fraud waste and...waste and our financial recovery. The Senior Payment Integrity Professional work assignments involve moderately complex to complex issues… more