- Oracle (Tallahassee, FL)
- …and regulatory knowledge (eg, medical necessity, level of care, clinical validation) to lead the appeals initiative to review denied claims , create write-ups for ... coding by applying power of generative AI. Our diverse team of creators and inventors are building the future...this exciting arena. We are looking for a Senior Claims Denial Prevention and Appeals Specialist for providing clinical… more
- Towne Park (Madeira Beach, FL)
- …day and make an impact. When we see a customer, a client or one of our own team members smile, we know we made an impact. It's why we do what we do. Towne Park ... the ability to positively move the metrics for forecasting, productivity, claims , customer service, and turnover + Manages scheduling, overtime for associates… more
- Sedgwick (Miami, FL)
- …are met + Assists with escalations + Acts as a backup for the team lead and mentors less experience specialists. **ADDITIONAL FUNCTIONS and RESPONSIBILITIES** + ... Performs and completes complex clinical reviews of referred medical claims to ensure accurate information is received by employees...constructive written reports + Ability to work in a team environment + Ability to meet or exceed Performance… more
- Elevance Health (Tampa, FL)
- **Be Part of an Extraordinary Team ** Carelon Payment Integrity is a proud member of the Elevance Health family of companies, Carelon Insights, formerly Payment ... auditing inpatient medical records and generating high quality recoverable claims for the benefit of the company, for all...is designed to advance our strategy but will also lead to personal and professional growth for our associates.… more
- Otsuka America Pharmaceutical Inc. (Tallahassee, FL)
- …President, CNS Business & Customer Engagement Operations business unit. **Job Description** + Lead a team responsible for developing access strategies and access ... is staffed with top talent within the industry + Lead a team to define the strategies...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more
- MyFlorida (Daytona Beach, FL)
- …Minimum - Must have 2 years experience of dental billing Must have2 years experience of Team Lead /Supervisor Must be a current State of Florida employee, in a ... the Accounts Payable, Accounts Receivable and Billing Operations. This position is the Lead role in the Dental Accounts Receivable and Billing Operations of multiple… more
- USAA (Tampa, FL)
- …assistance is not available for this position. **These positions will support Claims Litigations.** **What you'll do:** + Develop and implement strategic customer ... influence appropriate roadmap(s). + Apply expert knowledge of the business and lead the alignment and development of business deliverable processes and capabilities… more
- Carnival Cruise Line (Miami, FL)
- …the daily operations of crew case management. The Manager leads a team of specialists to ensure timely, empathetic communication and resolution of high-complexity ... reviewing care plans, coordinating with internal stakeholders, supporting disability claims , and facilitating return-to-work planning. The Manager also escalates… more
- Prime Therapeutics (Tallahassee, FL)
- …The Senior Clinical Research Analyst works closely with Prime's Health Outcomes Research team to lead clinical research projects that measure, and report ... the synthesis of data findings in support of clinical claims and programs. **Responsibilities** + Synthesizes a wide variety...various levels within the organization + Serves as the lead analyst in producing reports, scorecards, or other data… more
- Otsuka America Pharmaceutical Inc. (Tallahassee, FL)
- …customers + Develop an CNS wide portfolio value proposition for market access customers + Lead the team to develop and implement payer pull-through material + ... Lead the team to develop and refine...Lead the team to develop and refine the payer value proposition...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more