- 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
- Zelis (St. Petersburg, FL)
- …So, let's get to it! A Little About Us Zelis is modernizing the healthcare financial experience across payers, providers, and healthcare consumers. We serve more ... top five national health plans, regional health plans, TPAs and millions of healthcare providers and consumers across our platform of solutions. Zelis sees across… more
- Elevance Health (Tampa, FL)
- …+ Performs in-depth investigations on identified providers as warranted. + Examines claims for compliance with relevant billing and processing guidelines and to ... prevention and control. + Review and conducts analysis of claims and medical records prior to payment. + Researches...and medical records prior to payment. + Researches new healthcare related questions as necessary to aid in investigations.… more
- Healthfirst (FL)
- …in Healthcare /Health Plan customer service, operations, vendor management, or claims processing. + Previous work experience in an auditing function conducting ... understanding of healthcare Operations processes and supporting systems such as Claims Processing, Enrollment & Billing, and Member Services. + Knowledge of at… more
- Otsuka America Pharmaceutical Inc. (Tallahassee, FL)
- **Company Overview:** Otsuka is a global healthcare company driven by our purpose "to defy limitation, so that others can too." Patients are at the center of our ... purpose as we seek to discover and deliver innovative healthcare solutions. Otsuka is a leader in the CNS...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more
- Prime Therapeutics (Tallahassee, FL)
- …in Microsoft Word, Excel, Project, PowerPoint, and Visio **Preferred Qualifications** + Rx Claims system proficiency + Previous PBM or healthcare experience + ... experience in at least one of the specific areas for position (eg, claims , eligibility, product, benefits, implementations or related area) + Must be eligible to… more
- Otsuka America Pharmaceutical Inc. (Jacksonville, FL)
- **Job Summary** Otsuka America Pharmaceutical Inc. is a global healthcare company with the corporate philosophy: "Otsuka-people creating new products for better ... In its evolved customer engagement model, a Neuroscience Specialist engages healthcare providers (HCPs) using in-person, virtual, and digital tools, offering… more
- ChenMed (Greenacres, FL)
- …and procedures. Employees models and delivers the highest level of quality healthcare while working directly with patients and their families, doctors and other ... with the Pharmacy Technician Code of Conduct. + Helps healthcare providers and patients by greeting them in person...drugs. + Maintains knowledge of asset protection techniques, creates claims for order errors and damaged goods. + Maintains… more
- Carnival Cruise Line (Miami, FL)
- …planning in compliance with regulations and employment obligations. + Support disability claims and benefits review for crew unable to return to duty. + ... to assess fitness for duty per International Maritime Health guidelines. + **Crew Medical Claims Management** + Review crew cases of high risk and escalate to the… more
- Elevance Health (Tampa, FL)
- …I** is responsible for accurate and timely maintenance of provider information on claims and provider databases. **How You Will Make an Impact** Primary duties may ... to: + Assists in synchronization of data among multiple claims systems and application of business rules as they...dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with… more