- HCA Healthcare (Brandon, FL)
- …Medical Business Office Specialist? At Brandon Surgery Center, you come first. HCA Healthcare has committed up to $300 million in programs to support our incredible ... + Employee Stock Purchase Plan with 10% off HCA Healthcare stock + Family support through fertility and family...and insurance information to ensure accurate coding, billing and claims submission. What you will do: + You will… more
- Elevance Health (Miami, FL)
- …systems/tools to accurately document determinations and continue to next step in the claims lifecycle. + Researches new healthcare related questions as necessary ... abuse. **How you will make an impact:** + Examines claims for compliance with relevant billing and processing guidelines...dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with… more
- Molina Healthcare (FL)
- …and appropriateness of appeals according to state and federal and Molina Healthcare guidelines. + Requests and obtains medical records, notes, and/or detailed bills ... **I** **E** **N** **C** **E:** + 1 year of Molina experience, health claims experience, OR one year of customer service/provider service experience in a managed… more
- Molina Healthcare (Jacksonville, FL)
- …experience working in Medicare + Must have experience analyzing claims . **Job Qualifications** **REQUIRED EDUCATION:** Associate's Degree and/or equivalent ... care industry in related field **PREFERRED EDUCATION:** Bachelor's degree in healthcare related field **PREFERRED EXPERIENCE:** 4-6 years experience in healthcare… more
- Molina Healthcare (Tampa, FL)
- …Experience** 7-9 years Application Design, Development Experience and, Management, Healthcare Industry **Preferred Experience** 10+ years, Healthcare Industry ... with AI Data Integration._** + **_Experience with Member, Enrollment, and Claims applications -_** **which underpin essential business functions such as HEDIS… more
- Molina Healthcare (Orlando, FL)
- …Description** **Job Summary** Molina's Credentialing function ensures that the Molina Healthcare provider network consists of providers that meet all regulatory and ... credentialing database necessary for processing of recredentialing applications. * Reviews claims payment systems to determine provider status, as necessary. Ongoing… more
- Molina Healthcare (Miami, FL)
- …DESCRIPTION** **Job Summary** Molina's Credentialing function ensures that the Molina Healthcare provider network consists of providers that meet all regulatory and ... credentialing database necessary for processing of recredentialing applications. * Reviews claims payment systems to determine provider status, as necessary. *… more
- Molina Healthcare (Jacksonville, FL)
- …pharmacy prior authorization requests and/or appeals. + Explains Point of Sale claims adjudication, state, NCQA, and CMS policy/guidelines, and any other necessary ... **Preferred Education** Associate degree **Preferred Experience** + 3-5 years; healthcare industry experience preferred + National pharmacy technician certification… more
- Molina Healthcare (Jacksonville, FL)
- …member eligibility and covered benefits, Provider Portal, and status of submitted claims . * Ability to effectively communicate in a professionally setting. **Job ... for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare … more
- Molina Healthcare (Orlando, FL)
- …+ SQL expertise + Excel expertise + Medicare, Medicaid, Marketplace claims expertise **PHYSICAL DEMANDS:** Working environment is generally favorable and lighting ... for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare … more