- Elevance Health (Tampa, FL)
- …+ Performs in-depth investigations on identified providers as warranted. + Examines claims for compliance with relevant billing and processing guidelines and ... prevention and control. + Review and conducts analysis of claims and medical records prior to payment. Researches new... and medical records prior to payment. Researches new healthcare -related questions as necessary to aid in investigations. +… more
- Evolent (Tallahassee, FL)
- …customer accounts + Strong knowledge of health plan operations, care/utilization management, claims processing , value-based care, and the levers to optimize ... Experience we look for:** + Master's degree in business administration, healthcare administration, public health, analytics, or a related field, master's degree… more
- Humana (Tallahassee, FL)
- …to make an impact** **Required Qualifications** + 1 - 5 years or more of claims processing experience + Minimum of 1 year experience in conducting thorough root ... first** The Encounter Data Management Professional ensures data integrity for claims errors. The Encounter Data Management Professional work assignments are varied… more
- Humana (Tallahassee, FL)
- …of experience researching MS-DRG, APR-DRG and/or EAPG grouper logic + Experience processing or reviewing facility claims + Prior professional experience ... IT, the pricing software vendor, CIS BSS, Medicaid operations, claims operations, and other business teams involved in the...benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also… more
- LogixHealth (Dania Beach, FL)
- …individual providers and monitor contract termination dates and make sure that claims are processed based on the contracted rates. Key Responsibilities: + Assigning ... or equivalent combination of education and experience + Prior word processing , spreadsheet and internet software experience including proficiency with MS Teams,… more
- Walgreens (Bradenton, FL)
- …enhancements to pharmacy systems to further promote productivity. + Ensures the accurate processing of insurance claims to resolve customer issues and prevent ... usage of medications, awareness with drug interactions and offering preventive healthcare services such as immunizations. Responsible for ensuring the proper… more
- LogixHealth (Dania Beach, FL)
- …collaborative environment and bring your expertise to ensure groups can submit claims to insurance carriers for reimbursement . The ideal candidate will have ... + Minimum of one year provider enrollment experience + Prior word processing , spreadsheet, and internet software experience including proficiency with MS Teams,… more
- Walgreens (Kissimmee, FL)
- …enhancements to pharmacy systems to further promote productivity. + Ensures the accurate processing of insurance claims to resolve customer issues and prevent ... usage of medications, awareness with drug interactions and offering preventive healthcare services such as immunizations. Responsible for ensuring the proper… more
- AdventHealth (Maitland, FL)
- …care issues by collecting and interpreting contract performance information (eg claims volumes, quality and efficiency reports, participation gap analysis, accounts ... new product lines, benefit design, etc.) to appropriately respond to perceived healthcare market changes. DEADLINES AND TIMELINESS (10%) + Manages tasks to… more
- ZOLL Medical Corporation (Miami, FL)
- …involving continuing provision of ZOLL products/services with physicians, other healthcare professionals and support staff.Essential Functions + Visit ZOLL customers ... clinically appropriate cases. Determine independently and work collaboratively with office staff/ healthcare provider to bring patient's case to the staff's attention… more