- BayCare Health System (Clearwater, FL)
- …documentation, and medical records. + Triage, plan, and execute intake of Appeals and Grievance submissions. + Keeping track of deadlines, ensuring all necessary ... Identify trends or recurring issues in member grievances and appeals and recommend process improvements to prevent future occurrences....years Customer Service (or similar) within a healthcare or insurance environment with HS/GED; Or - 1 year -… more
- Elevance Health (FL)
- …and/or serve as a subject matter expert. + Perform first level provider appeals as designated by the client for adverse determinations. + Obtain additional state ... for services requested. + Makes medical necessity determinations for grievance and appeals appropriate for their specialty. + Ensures consistent use of company… more
- Sarasota County Government (Sarasota, FL)
- …provide informed recommendations. + Draft Zoning Letters of Determination and support appeals , development reviews, and Board of Zoning Appeals activities under ... + Enjoy great benefits including Health, Dental, Vision, and Life Insurance , Short-Term and Long-Term Disability, Flexible Spending Accounts, Employee Assistance… more
- CHS (Clearwater, FL)
- **Overview** **Claims Manager** **Servicing** **Health Insurance Policies or Benefits** **Summary:** Premier Administrative Solutions (PAS) is a Third-Party ... (TPA) which provides a wide range of administrative services to insurance companies, sharing organizations, insurance marketing organizations, and employers.… more
- Cardinal Health (Tallahassee, FL)
- …relationships of trust with customers and internal business partners. The Insurance Follow-up Collector generates revenue by monitoring and pursuing payment on ... goals to maximize cash flow. Responsibilities + Reverification of insurance benefits if missed by front office + Able...importance and relationship to patient care + Consults with appeals department for disputed / denied claims. + Works… more
- Owens & Minor (Tallahassee, FL)
- …teammates. Owens & Minor teammate benefits include: + Medical, dental, and vision insurance , available on first working day + 401(k), eligibility after one year of ... + Tuition reimbursement **JOB SUMMARY** The collections representative follows-up with insurance companies to resolve unpaid claims. The anticipated salary range for… more
- Humana (Tallahassee, FL)
- …other Medical management organizations, hospitals/ Integrated Delivery Systems, health insurance , other healthcare providers, clinical group practice management. + ... review organization, such as Medicare Advantage, managed Medicaid, or Commercial health insurance . + Experience with national guidelines such as MCG(R) or InterQual… more
- United Therapeutics (Melbourne, FL)
- …information in an efficient manner + Communicate with healthcare providers, insurance plans, patients, and their authorized representatives as needed. Triage ... and UT copay programs policies, procedures, business rules, related operations, and insurance requirement for UT products + Complete special projects with limited… more
- Cardinal Health (Tallahassee, FL)
- …with various healthcare providers, including physicians, specialty pharmacies, and insurance companies, to ensure seamless coordination of patient care and ... timely access to necessary services + Assist in obtaining insurance , prior authorization, and appeal requirements and outcomes + Help patients understand their … more
- Humana (Tallahassee, FL)
- …other Medical management organizations, hospitals/ Integrated Delivery Systems, health insurance , other healthcare providers, clinical group practice management. + ... review organization, such as Medicare Advantage, managed Medicaid, or Commercial health insurance . + Experience with national guidelines such as MCG(R) or InterQual… more