- AdventHealth (Altamonte Springs, FL)
- …to appropriately reconcile patient accounts. Resolves and resubmits rejected claims appropriately as necessary. Processes daily and special reports, unlisted ... + Works with insurance payers to ensure proper billing, collections, or denial management on patient accounts. Depending on payer contract may be required to… more
- CVS Health (Tallahassee, FL)
- …Provide excellent customer services for high volume inbound provider calls for the Claims Inquiry/ Claims Research Medicaid team. Extensive claims research on ... all colleagues** including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. + **Benefit… more
- CVS Health (Tallahassee, FL)
- …day. **Position Summary** Reviews and adjudicates complex, sensitive, and/or specialized claims in accordance with plan processing guidelines. Acts as a subject ... customer service inquiries and problems. **Additional Responsibilities:** Reviews pre-specified claims or claims that exceed specialist adjudication authority… more
- Banner Health (FL)
- …and billing codes. Works with clinical documentation improvement and quality management staff to: align diagnosis coding to documentation to improve the ... Assists in creating a department-wide focus of performance improvement and quality management . Assists and participates with management through committees to… more
- LCEC (North Fort Myers, FL)
- …Plan + On-site wellness/medical facility + Company paid Short & Long-Term Disability insurance + Health Savings Account with an employer contribution + Flexible ... development, implementation, and oversight of the electric utility's enterprise risk management (ERM) and regulatory compliance programs. This position ensures that… more
- Sedgwick (Tallahassee, FL)
- …and assure efficient, cost effective, quality program delivery for medical and disability management . + Coordinating and evaluating the service delivery between ... on cases where the nurse is seeking treatment plan clarification, claim denial, disability certification or duration management for return to work guidance. +… more
- Evolent (Tallahassee, FL)
- …at customer accounts + Strong knowledge of health plan operations, care/utilization management , claims processing, value-based care, and the levers to optimize ... client and organizational objectives. **What You Will Be Doing:** **Account/ Relations Management ** - provide corporate, executive and overall account management … more
- USAA (Tampa, FL)
- …implementation to enable process redesign and innovation. Leads the overall management of process performance by developing control limits, monitoring key ... and/or process engineering/optimization. + Experience in successfully applying quality management , process improvement, and problem-solving tools and methodologies. +… more
- Mass Markets (FL)
- …account management tasks + Accurately document and process customer claims in appropriate systems + Follow all required scripts, policies, and procedures ... Temporary and Administrative Professional Staffing (TAPS Schedule 736), Business Process Management (BPM), Business Process Outsourcing (BPO), Claims Processing,… more
- Mass Markets (FL)
- …Temporary and Administrative Professional Staffing (TAPS Schedule 736), Business Process Management (BPM), Business Process Outsourcing (BPO), Claims Processing, ... and retention. + Respond to customer inquiries regarding coverage, benefits, claims , and other insurance-related questions. + Maintain accurate and up-to-date… more