- Community Health Systems (Naples, FL)
- …risk management, patient safety, and regulatory compliance across Physicians Regional Healthcare System. This role ensures compliance with federal, state, and local ... Safety Officer or collaborate with one to support quality and safety initiatives. ** Claims & Litigation Management** + Oversee legal claims processes, including… more
- Akumin (FL)
- …The **Medical Collector** contacts payers for status of payment of outstanding claims , including commercial and government carriers, and patient liabilities in the ... appropriate time frame. Responsible for rebilling of all claims as needed, including correction of missing/inaccurate data, and appeals of denied claims with… more
- CVS Health (Tallahassee, FL)
- …representatives that are responsible for contacting payers to collect on unpaid claims in a timely and accurate manner, researching and resolving payment variances, ... and managing the accurate and timely filing of claims within payer function group. **Additional responsibilities of the Accounts Receivable Supervisor include:** +… more
- Sharecare (Tallahassee, FL)
- …2-yr associates degree in healthcare /health sciences OR equivalent experience in healthcare , preferably helping members navigate benefits and claims , OR held ... through personalized resource and referral facilitation, issue resolution and healthcare navigation. Utilizing motivational interviewing and guided approaches, the… more
- Elevance Health (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 ... Requires a minimum of 10 years of experience in claims auditing, quality assurance, or clinical documentation improvement, and...dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with… more
- Elevance Health (Miami, FL)
- …with external accreditation and regulatory requirements, internal policies and claims events requiring adaptation of written response in clear, understandable ... and analyze the grievance and appeal issue(s) and pertinent claims and medical records to either approve or summarize...dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with… more
- Humana (Tallahassee, FL)
- …**Required Qualifications** + Bachelors Degree + Minimum of 3 years of medical claims auditing experience (interpreting if claims initially paid correctly in the ... Payment Integrity (formally known as Financial Recovery) experience + CAS claims knowledge + Prior vendor relationship experience/knowledge + Intermediate knowledge… more
- Otsuka America Pharmaceutical Inc. (Tallahassee, FL)
- …enhance communication strategies, ensuring seamless and personalized interactions with healthcare professionals (HCPs) and key opinion leaders (KOLs). **Job ... Management** + Explore and analyze common pharmaceuticals data (eg, claims ) as well as novel data sets based on...performance. + Agile skills and experience + Experience in Healthcare (esp. US) industry is a plus. **Competencies** **Accountability… more
- Carnival Cruise Line (Miami, FL)
- …reviewing care plans, coordinating with internal stakeholders, supporting disability claims , and facilitating return-to-work planning. The Manager also escalates ... planning in compliance with regulations and employment obligations. + Support disability claims and benefits review for crew unable to return to duty. +… more
- Elevance Health (Miami, FL)
- …eligible for employment based sponsorship. **Ensures accurate adjudication of claims , by translating medical policies, reimbursement policies, and clinical editing ... to system inquiries and appeals. + Conducts research of claims systems and system edits to identify adjudication issues...dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with… more