- Humana (Tallahassee, FL)
- …from either the state agency or payer perspective + Detailed understanding of healthcare claims Travel: While this is a remote position, occasional travel ... benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also...our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions… more
- Elevance Health (FL)
- …data analysis preferred. + Practical business experience preferred. + Experience in healthcare claims , health care benefits/total rewards and data analysis ... dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with...Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of… more
- Highmark Health (Tallahassee, FL)
- …You will proactively identify opportunities to construct and leverage comprehensive healthcare knowledge graphs, integrating diverse patient, provider, claims , ... from concept to prototype. + ** Healthcare Data Familiarity:** Understanding of healthcare data domains ( claims , clinical, EMR) and related ontologies or… more
- Molina Healthcare (Miami, FL)
- …Description** **Job Summary** Responsible for work load assignment to the provider Claims adjudicators and senior provider claims adjudicators. Train and coach ... new employees. Provide clear and concise results on the provider claims model across all states. Monitors and controls workflow. Provides support to leadership… more
- Molina Healthcare (Miami, FL)
- **Job Description** **Job Summary** The Provider Claims Adjudicator is responsible for responding to providers regarding issues with claims , coordinating, ... investigates and confirms the appropriate resolution of claims issues. This role will require actively researching issues to adjudicate claims Requires knowledge… more
- Molina Healthcare (Orlando, FL)
- **JOB DESCRIPTION** **Job Summary** Responsible for administering claims payments, maintaining claim records. Monitors and controls backlog and workflow of claims ... **KNOWLEDGE/SKILLS/ABILITIES** + Meets and consistently maintains production standards for Claims Adjudication. + Supports all department initiatives in improving… more
- Molina Healthcare (Miami, FL)
- **JOB DESCRIPTION** **Job Summary** Responsible for administering claims payments, maintaining claim records. Monitors and controls backlog and workflow of claims ... cost control standards. **KNOWLEDGE/SKILLS/ABILITIES** + Evaluates the adjudication of claims using standard principles and state specific policies and regulations… more
- HCA Healthcare (Port Charlotte, FL)
- …as a Medical Insurance Claims Specialist? At Parallon, you come first. HCA Healthcare has committed up to $300 million in programs to support our incredible team ... + Employee Stock Purchase Plan with 10% off HCA Healthcare stock + Family support through fertility and family...difference. We are looking for a dedicated Medical Insurance Claims Specialist like you to be a part of… more
- Molina Healthcare (Jacksonville, FL)
- **JOB DESCRIPTION** **Job Summary** Responsible for administering claims payments, maintaining claim records, and providing counsel to claimants regarding coverage ... amount and benefit interpretation. Monitors and controls backlog and workflow of claims . Ensures that claims are settled in a timely fashion and in accordance… more
- DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
- Position Purpose: The Claims Examiner is responsible for providing expertise and/or claims support in reviewing, researching, investigating, processing and ... adjusting claims and other duties as necessary. Key Responsibilities: +...Key Responsibilities: + Review, research, analyze and process professional claims by navigating multiple applications and platforms accurately. +… more