- AssistRx (Orlando, FL)
- …reimbursement, Sites of Care and Health Care Providers. The Copay Support/ Claims Processing Specialist will adjudication , troubleshoot claim rejections, ... teams on enrollment discrepancies (missing info and duplicates) + Partners with claim adjudication vendors ensure proper claims processing and data… more
- CHS (Clearwater, FL)
- …insurance companies, employers, and members. In this pivotal role, you'll oversee claims adjudication , drive operational strategy, and ensure high accuracy and ... clients. * Management of relationships with essential vendors involved with the Claims Adjudication process, including clearinghouses, claims cost control… more
- Sedgwick (Tallahassee, FL)
- …client service requirements. **ESSENTIAL RESPONSIBLITIES MAY INCLUDE** + Analyzing and processing claims through well-developed action plans to an appropriate ... behalf of our valued clients to determine benefits due, while ensuring ongoing adjudication of claims within service expectations, industry best practices, and… more
- Sedgwick (Tallahassee, FL)
- …growth, and inclusion. **ESSENTIAL RESPONSIBILITIES MAY INCLUDE** + Analyzing and processing claims through well-developed action plans to an appropriate ... behalf of our valued clients to determine benefits due, while ensuring ongoing adjudication of claims within service expectations, industry best practices, and… more
- Sedgwick (Tallahassee, FL)
- …exposure claims involving litigation and rehabilitation; to ensure ongoing adjudication of claims within service expectations, industry best practices and ... Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Examiner | Multi-Line | Public Entity | Remote...professional and timely manner. + Communicates claim activity and processing with the claimant, insured, client and agent or… more
- Sedgwick (Tallahassee, FL)
- …exposure claims involving litigation and rehabilitation; to ensure ongoing adjudication of claims within service expectations, industry best practices and ... as a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Examiner | General Liability BI | Captive | Remote As a Claims … more
- TEKsystems (Orlando, FL)
- …or medical claims . You'll play a key role in ensuring the accuracy of claims processing and supporting the transition to a new adjudication platform. Key ... Qualifications + 5+ years experience in medical or pharmacy claims processing . + 3+ years of experience...employee and dependents) * Short and long-term disability * Health Spending Account (HSA) * Transportation benefits * Employee… more
- AdventHealth (Apopka, FL)
- …for all activities regarding Rx Plus Pharmacy's state licensed data entry, claims adjudication , prior authorization, pharmacy specialist, and technician quality ... of prescription order intake of various media, technician quality assurance, claims adjudication and copay assistance, prior authorization, and prescription… more
- CVS Health (Tallahassee, FL)
- …Reviews pre-specified claims or claims that exceed specialist adjudication authority or processing expertise. - Applies medical necessity guidelines, ... At CVS Health , we're building a world of health...**Position Summary** Reviews and adjudicates complex, sensitive, and/or specialized claims in accordance with plan processing guidelines.… more
- AdventHealth (Maitland, FL)
- … claims for all provider types Managed Care, Patient Financial services, health insurance claims processing , contract management, or medical economics ... reimbursement methodologies Applies detailed understanding of medical coding systems affecting the adjudication of claims to include ICD-9/10 CPT, CPT, HCPCS II,… more
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