- CHS (Clearwater, FL)
- **Overview** ** Health Insurance Medical Claims Examiner** **Monday-Friday Schedule with daytime hours** **Responsibilities** **Summary:** The Medical Claims ... Examiner adjudicates medical claims based on health policy provisions and established guidelines. **Essential Duties and Responsibilities:** + Reviews 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
- Humana (Tallahassee, FL)
- **Become a part of our caring community and help us put health first** The Bilingual Claims Research & Resolution Representative 2 manages claims operations ... that involve customer contact, investigation, and resolution of claims or claims -related financial issues. The position...us** Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and… more
- Molina Healthcare (St. Petersburg, FL)
- …simple to complex claims payments using tools such as Department of Health and Human Services (DSHS) and Medicare billing guidelines, Molina claims ... Office suite and applicable software programs proficiency. **Preferred Qualifications** * Claims recovery experience. * Health insurance experience in a… more
- Molina Healthcare (FL)
- … environment, or equivalent combination of relevant education and experience. * Health claims processing experience, including coordination of benefits (COB), ... JOB DESCRIPTION Job Summary Provides support for claims activities including reviewing and resolving member and...program), or medical office/hospital setting. * Completion of a health care related vocational program in health … more
- Molina Healthcare (Miami, FL)
- … environment, or equivalent combination of relevant education and experience. * Health claims processing experience, including coordination of benefits (COB), ... JOB DESCRIPTION Provides support for claims activities including reviewing and resolving **Provider No...program), or medical office/hospital setting. * Completion of a health care related vocational program in health … more
- Molina Healthcare (Tampa, 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
- AdventHealth (Maitland, FL)
- …claims for all provider types Managed Care, Patient Financial services, health insurance claims processing, contract management, or medical economics ... Benefits from Day One Career Development Whole Person Wellbeing Resources Mental Health Resources and Support **Our promise to you:** Joining AdventHealth is about… more
- GE Aerospace (Jacksonville, FL)
- …terminology and medical impairments related to long term care, disability, life and/or health insurance claims + Note: Position can be hybrid or remoteThe ... In this high-impact role, you'll deliver sharp insights, adjudicate complex claims , and collaborate across teams using advanced analytics and emerging technology.… more
- City of Lakeland (Lakeland, FL)
- …loss prevention, and wellness initiatives/clinic. Responsibilities include directly supervising Safety, Health Benefits, and Claims Team Leaders; Risk Management ... state and federal agencies dealing with insurance, safety, and health and wellness. + Monitors all claims ...and health and wellness. + Monitors all claims activity, providing a forum for discussion and adjustment… more