- Highmark Health (Tallahassee, FL)
- …knowledge about the shifting healthcare environment including trends concerning health insurance , healthcare delivery, provider relationships and regulatory ... coding languages, analytical software, systems, tools and processes using claims , clinical, enrollment and provider data + 5 years...with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996… more
- Elevance Health (Tampa, FL)
- …is responsible for auditing inpatient medical records and generating high quality recoverable claims for the benefit of the company, for all lines of business, and ... submitted DRG. **How you will make an impact:** + Analyzes and audits claims by integrating medical chart coding principles, clinical guidelines and objectivity in… more
- Elevance Health (Tampa, FL)
- …Audit Facilitator** is responsible for managing the process for claims and customer service audits/quality control reviews, including implementation audits, ... scope presented by external auditor. + For implementation audits, ensures the claims system is coded accurately by independently developing and running test … more
- Elevance Health (Tampa, FL)
- …is not eligible for current or future VISA sponsorship._ The **Rating/ Claims System Analyst Sr** is responsible for providing support, configuration, design, ... testing and implementation for claims systems. Ensures accurate adjudication of claims ,...+ CPC highly preferred. Please be advised that Elevance Health only accepts resumes for compensation from agencies that… more
- University of Miami (Miami, FL)
- …to obtain additional information when necessary. + Responds to customer inquiries regarding insurance coverage for services and processing of claims . + Adheres ... this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . The University of Miami Health System, "UHealth", Department of Pediatrics-Early Steps has an… more
- Elevance Health (Tampa, FL)
- …the enterprise. Included are processes related to enrollment and billing and claims processing, as well as customer service written and verbal inquiries. **How ... related experience in quality audit capacity (preferably in the healthcare or insurance sector); or any combination of education and experience which would provide… more
- University of Miami (Doral, FL)
- …to obtain additional information when necessary. + Responds to customer inquiries regarding insurance coverage for services and processing of claims . + Adheres ... of Miami UHealth has an exciting opportunity for an Insurance Verification Representative (H) to work at Doral Commons.... information. + Obtains authorization for HMO patients. Verifies claims are mailed to the proper address. + Contacts… more
- Elevance Health (Tampa, FL)
- …be considered. Carelon Payment Integrity is a proud member of the Elevance Health family of companies, Carelon Insights, formerly Payment Integrity, is determined to ... abuse. **How you will make an impact:** + Examines claims for compliance with relevant billing and processing guidelines...Medicare/Medicaid is a plus. Please be advised that Elevance Health only accepts resumes for compensation from agencies that… more
- Elevance Health (Tampa, FL)
- …and DRGs billed and reimbursed. Specializes in review of Diagnosis Related Group (DRG) paid claims . **How you will make an impact:** + Analyzes and audits claims ... applicable state(s). + Requires a minimum of 10 years of experience in claims auditing, quality assurance, or clinical documentation improvement, and a minimum of 5… more
- Otsuka America Pharmaceutical Inc. (Tallahassee, FL)
- **About Otsuka Precision Health ** Founded on Otsuka's rich history in delivering breakthrough innovations to solve complex problems for patients, Otsuka Precision ... Health (OPH) is the next step in our evolution....group medical, dental and vision coverage, life and disability insurance , and flexible spending accounts + A discretionary annual… more