- Sharecare (Tallahassee, FL)
- …eligibility, benefit education, open enrollment / new hire plan selection, claims issues, ID card issues, grievances/appeals, utilization management (UM) status, ... including but not limited to medical, dental , and vision plans + Provider search (PCP, specialty,...resolution with providers, payers or 3rd parties for: + Claims adjustments + Grievances and appeals submissions + Utilization… more
- Sedgwick (Tallahassee, FL)
- …support systems. + Effectively communicates and builds relationships with the claims ' examiner, client, injured worker, attorney and supervisor. + Identifies issues ... same vision/goals. + We offer a diverse and comprehensive benefits including medical, dental vision, 401K, PTO and more beginning your first day. **NEXT STEPS** If… more
- Orlando Utilities Commission (Orlando, FL)
- …package includes to cite a few:** + Competitive compensation + Low-cost medical, dental , and vision benefits and paid life insurance premiums with no probationary ... positive communication and assistance. + Manages the administration of medical, dental , vision, and other health benefits, including data tracking and reporting.… more
- Elevance Health (Tampa, FL)
- …with fraud and abuse. **How you will make an impact:** + Examines claims for compliance with relevant billing and processing guidelines and identifies opportunities ... fraud and abuse prevention and control. + Reviews and conducts analysis of claims and medical records prior to payment and uses required systems/tools to accurately… more
- Cognizant (Tallahassee, FL)
- …satisfaction. **Responsibilities:** Reviewing available Appeals & Grievances for the pending claims to verify due process was followed. Determine if the appeal ... or Grievance is legitimate. A strong understanding of Claims , Appeals and Medical Benefits. Referring suspicious or complicated Claims to investigators.… more
- Elevance Health (Miami, FL)
- …eligible for employment based sponsorship. **Ensures accurate adjudication of claims , by translating medical policies, reimbursement policies, and clinical editing ... research and responds to system inquiries and appeals. + Conducts research of claims systems and system edits to identify adjudication issues and to audit … more
- Walmart (Orlando, FL)
- …rotating merchandise and supplies from distribution centers and suppliers handling claims and returns completing maintaining and securing paperwork forms and other ... example systems insurance stock processing information for thirdparty insurance claims coordinating with insurance companies to resolve rejections interpreting… more
- AECOM (Tampa, FL)
- …+ Work with management and staff to resolve pre-litigation disputes and potential claims + Manage various types of litigation matters and claims utilizing ... experience at an engineering, architecture or construction company + Claims /litigation handling, including management of outside counsel, relating to architecture,… more
- Elevance Health (Miami, FL)
- …with fraud and abuse. **How you will make an impact:** + Examines claims for compliance with relevant billing and processing guidelines and identifies opportunities ... fraud and abuse prevention and control. + Reviews and conducts analysis of claims and medical records prior to payment and uses required systems/tools to accurately… more
- Otsuka America Pharmaceutical Inc. (Tallahassee, FL)
- …a minimum of 5 business days. **Company benefits:** Comprehensive medical, dental , vision, prescription drug coverage, company provided basic life, accidental death ... you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to...legitimate job opportunity. Scammers may also send offers or claims from a fake email address or from Yahoo,… more