- DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
- …or GED + Excellent oral and written communication skills + 1 - 3 years of Health claims processing experience + Working knowledge of COB and MSP preferably + ... Position Purpose: The Claims Examiner is responsible for providing expertise and/or...Claims Examiner is responsible for providing expertise and/or claims support in reviewing, researching, investigating, processing and adjusting… more
- CHS (Clearwater, FL)
- **Overview** ** Health Insurance Medical Claims Examiner** **(Initial Training On Site - 90 days - Remote position after training in FL)** **Must live within a ... **Summary:** The Medical Claims Examiner adjudicates medical claims based on health policy provisions and... Examiner adjudicates medical claims based on health policy provisions and established guidelines. **Essential Duties and… more
- CHS (Clearwater, FL)
- **Overview** ** Claims Manager** **Servicing** ** Health Insurance Policies or Benefits** **Summary:** Premier Administrative Solutions (PAS) is a Third-Party ... (ERM). Actual results will be compared to goals in each period. ** Claims Manager** ** Health Insurance Policies or Benefits** **Qualifications** **Qualifications… more
- Molina Healthcare (Orlando, FL)
- …+ Min. 2 years operational managed care experience (call center, appeals or claims environment). + Health claims processing background, including ... to ensure that internal and/or regulatory timelines are met. + Research claims appeals and grievances using support systems to determine appeal and grievance… more
- Elevance Health (FL)
- …data scientists, statisticians and actuaries preferred. + Experience working with large health claims datasets or gathering datasets. Experience with evaluation ... track record and recent industry and vendor knowledge in evaluating traditional health plans, emerging health plans, Value Based Care arrangements, surgical… more
- Elevance Health (Altamonte Springs, FL)
- …The **Credit and Collections Specialist** is responsible for collection activities related health insurance claims and patient balances. **How You Will Make ... the purpose of collecting past due insurance premiums and/or past due health insurance claims . + Researches validity of past due and/or disputed debt. +… more
- Elevance Health (Altamonte Springs, FL)
- …activities related to past due health insurance premiums and/or past due health insurance claims **How you will make an impact:** + Follows established ... the purpose of collecting past due insurance premiums and/or past due health insurance claims . + Researches validity of past due and/or disputed debt. +… more
- BD (Becton, Dickinson and Company) (Stuart, FL)
- …for all covered services provided by or to our members under their health insurance plans. **Responsibilities:** + Process healthcare claims according to ... of the largest global medical technology companies in the world. Advancing the world of health (TM) is our Purpose, and it's no small feat. It takes the imagination… more
- Prime Therapeutics (Tallahassee, FL)
- …Principal Solution Strategist for our NEW JUDI program. If you have experience with PBM/ health claims , love working in a fast-paced environment within a group ... issues and concerns and support collaborative problem solving **Preferred Qualifications** + PBM/ health experience - Claims + Experience working on and coaching… more
- Humana (Tallahassee, FL)
- **Become a part of our caring community and help us put health first** The Claims Risk Management Professional is responsible for ensuring payment quality of ... claims in accordance with TRICARE policy requirements. This role...us** Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and… more