- Humana (Tallahassee, FL)
- …problems within the encounter process between Humana and CMS using data analysis, claims research, and other resources to provide insight and ensure data integrity ... for Medicare/Medicaid claims errors. **Key Role Functions** + Develop business processes...x 10mpbs upload) is required.** **Satellite and Wireless Internet service is NOT allowed for this role.** **A dedicated… more
- Humana (Tallahassee, FL)
- …an impact** **Required Qualifications** + Minimum 1 year of experience in medical claims payment and processing + Minimum 1 year of experience analyzing and ... researching medical claims + Proficient in Microsoft Office (Word, Excel, Access,...10mpbs upload) is required. + Satellite and Wireless Internet service is NOT allowed for this role. + A… more
- Humana (Tallahassee, FL)
- …The Senior Encounter Data Management Professional ensures data integrity for claims errors. The Senior Encounter Data Management Professional work assignments ... make an impact** **Required Qualifications** + 5+ years of claims operations related experience + Experience with analyzing, reconciling...10mpbs upload) is required. + Satellite and Wireless Internet service is NOT allowed for this role. + A… more
- Humana (Tallahassee, FL)
- …Review/Insurance Billing) or Internal/External Audit or Regulatory/Compliance OR Claims Investigations or Criminal Investigation/White Collar Crime); interacting ... CPC, CCS, CFE, AHFI). * Understanding of healthcare industry, claims processing and investigative process development. * Experience in...10mpbs upload) is required. * Satellite and Wireless Internet service is NOT allowed for this role. * A… more
- Walgreens (Quincy, FL)
- …answers questions to ensure a positive customer experience. Models and shares customer service best practices with all team members to deliver a distinctive and ... interpersonal habits (eg, greeting, eye contact, courtesy, etc.) and Walgreens service traits (eg, offering help proactively, identifying needs, servicing until… more
- Molina Healthcare (St. Petersburg, FL)
- …responsible for the holistic management of the external vendor relationships for Claims and Enrollment activities (along with other Core Ops areas of ... onboarding of vendor resources, managing performance, monitoring, and mitigating risks to ensure service delivery by vendors is in accordance with the Service … more
- Prime Therapeutics (Tallahassee, FL)
- …D eligibility requirements, Part D plan designs, drug formularies, drug pricing, claims processing and reimbursements, True Out of Pocket expenditures, that ensure ... are not limited to premium amounts, late enrollment penalties, and reimbursement of drug claims . + Ensures the accuracy of payments to Part D sponsors. + Resolves… more
- Sedgwick (West Palm Beach, FL)
- …growing, industry-leading global company known for its excellence and customer service . + Celebrate your career achievements and each other through professional ... achieving recovery and autonomy through advocacy, communication, education, identification of service resources and service facilitation. + Identify appropriate… more
- Boar's Head Brand/Frank Brunckhorst Co., LLC (Sarasota, FL)
- …+ Creates and launches new document requests as needed to support labeling claims or new regulatory requirements. + Uses the Quality Management System to develop ... reports and dashboards needed to support Customer Service requirements, respond to retailer or other customer requests, evaluate vendor compliance status, and… more
- Travelers Insurance Company (Tampa, FL)
- …**What Will You Do?** + CUSTOMER ENGAGEMENT: Serves as a customer service representative for the claim department by promptly and professionally addressing customer ... department; Answers claim status and payment questions. + CLAIM OPERATIONAL SERVICE AND PARTNERSHIPS: Partners with claim professionals in multiple departments to… more