- DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
- …as well as knowledge of the interconnection between Utilization Management, claims , and regulatory requirements to respond to complex and/or escalated inquiries. ... who could benefit from care management and refers to the appropriate care manager . + Utilizes critical thinking skills to identify process issues and problems and… more
- CDM Smith (Boca Raton, FL)
- …assigned activities including critical path method (CPM), scheduling and claims administration. Interprets plans and specifications for clients, contractors, and ... gender identity or gender expression), national origin, age, marital status, disability , veteran status, citizenship status, genetic information or any other… more
- AECOM (Jacksonville, FL)
- …+ Assist in the preparation of contract documents, change orders, and claims analysis + Contribute to continuous improvement initiatives within the department and ... Advanced MOT + CTQP Final Estimates Level II + CTQP Quality Control Manager **Additional Information** + Relocation assistance is not available for this position +… more
- National Express (Jacksonville, FL)
- …Shares concerns about suspicious or inappropriate behavior with their supervisor or manager . + Other duties as assigned Company name is: Durham School Services ... events to ensure excellence in customer service. + Ability to Investigate claims and incidents of questionable conduct, accidents etc. + Computer literacy skills… more
- Surgery Care Affiliates (Jacksonville, FL)
- …and corrected claims collaborating with the biller and/or Business Office Manager , insurance payers and/or patients on past due accounts + Primary functions are ... coverage, 401k plan with company match, paid time off, life and disability insurance, and more. Click here (https://careers.sca.health/why-sca) to learn more about… more
- AdventHealth (Zephyrhills, FL)
- …develops and administers the Risk Management Program for loss prevention and claims control (according to federal, state, and local requirements) to meet the ... trends and sentinel events, with referral to the appropriate committee, manager , or individual for follow-up. Monitors process improvement. + Maintains familiarity… more
- AdventHealth (Altamonte Springs, FL)
- …Coding programs. Will work with Case Management, the Billing Office, Coding Manager , Clinical Documentation Improvement specialists and the coding team to code and ... Team of any coding or coding related issues that adversely impact the claims processing, coding accuracy, and compliance.e. Monitors the queue holds and adhere to… more
- LogixHealth (Dania, FL)
- …using software or other resource tools + Prepare audit results and keep department manager current of all findings and audits and advise as necessary + Train all ... health, dental and vision, 401(k), PTO, paid holidays, life and disability insurance, on-site fitness center and company-wide social events. About LogixHealth:… more
- The Cigna Group (Sunrise, FL)
- …an integral member of the Provider Contracting Team and reports to the Contracting Manager or Market Lead. This role assists and supports the day to day contracting ... of communication with matrix partners including but not limited to, Claims Operations, Medical Management. Credentialing, Legal, Medical Economics, Compliance, Sales… more
- CDM Smith (Fort Myers, FL)
- …activities, including critical path method (CPM), and scheduling and claims administration. Interprets plans and specifications for clients, contractors, and ... gender identity or gender expression), national origin, age, marital status, disability , veteran status, citizenship status, genetic information or any other… more