- ICW Group (Orlando, FL)
- …adherence to the daily and scheduled focused audit plan. + Conducts regular, ongoing review and analysis of all Claims Auditors to ensure audit quality and ... for Audit & Compliance program. + Works closely with training specialist and claims management staff to correct deficiencies and address technical training… more
- Polaris Pharmacy Services, LLC (Fort Lauderdale, FL)
- …Remote Position Type Full Time Job Category Pharmaceutical Description PRIOR AUTHORIZATION SPECIALIST (REMOTE) WHO WE ARE At Polaris Pharmacy Services, we're more ... it most, we invite you to grow with us. OVERVIEW The Prior Authorization Specialist is responsible for managing and identifying a portfolio of rejected pharmacy … more
- Cardinal Health (Tallahassee, FL)
- …- 3:30 PM PST (or based on business need)** **_What Accounts Receivable Specialist contributes to Cardinal Health_** Account Receivable Specialist is responsible ... for verifying patient insurance and benefits, preparing and submitting claims to payers, correcting rejected claims , following...other status protected by federal, state or local law._ _To read and review this privacy notice click_ here… more
- Cardinal Health (Doral, FL)
- …skills and prioritizes getting the right things done. **The Accounts Receivable Specialist II is responsible for processing insurance claims and billing. ... from AR & Billing leadership teams.** **_Responsibilities_** + Processes claims : investigates insurance claims ; and properly resolves...other status protected by federal, state or local law._ _To read and review this privacy notice click_ here… more
- Molina Healthcare (FL)
- …post pay claims with corresponding medical records to determine accuracy of claims payments. + Review of applicable policies, CPT guidelines, and provider ... and medical records to document relevant findings of a post pay clinical review . This position manages documents and prioritizes case load to ensure timely turn… more
- Elevance Health (Tampa, FL)
- …is responsible for auditing inpatient medical records and generating high quality recoverable claims for the benefit of the company, for all lines of business, and ... issues of coding and DRG assignment accuracy. Specializes in review of DRG coding via medical record and attending...you will make an impact:** + Analyzes and audits claims by integrating medical chart coding principles, clinical guidelines… more
- Butterfly Effects (Deerfield Beach, FL)
- …and resolve billing errors to reduce claim denials. + Correct and resubmit denied claims for billing errors. + Review and address immediate rejections from the ... difference! Butterfly Effects is looking for a Medical Billing Specialist to support our national billing needs. In this...national billing needs. In this role, you'll ensure clean claims and accurate submissions, allowing our field teams to… more
- AdventHealth (Tampa, FL)
- …for receiving and addressing accounts within 72 hours of being routed to the claims edit work queue and coding review needed work queue. Qualifications **T** ... billed as well as ensure we are billing clean claims . The APC Coordinator will assist in the oversight...education. **The val** **ue you'll bring to the team:** Review and analyze claim denials to perform the appropriate… more
- Molina Healthcare (Orlando, FL)
- …care experience in the specific programs supported by the plan such as utilization review , medical claims review , long-term services and supports (LTSS), or ... likelihood of a formal appeal being submitted. * Reevaluates medical claims and associated records independently by applying advanced clinical knowledge, knowledge… more
- MyFlorida (Largo, FL)
- …Tool (https://compcalculator.myflorida.com/) ACCOUNTANT III - HEALTH INSURANCE BILLING SPECIALIST FLORIDA DEPARTMENT OF VETERANS' AFFAIRS Agency Headquarters, Mary ... Accounts Receivable billing software systems. + Perform third party claims processing and collection activities for all payors of...any other payer for the State Veterans' Homes. + Review and monitor resident accounts ensuring that the account… more