- MyFlorida (Tampa, FL)
- …raised), handling all hearings and the preparation of post-trial proceedings. + Handle appeals from any of the foregoing proceedings to the United States Court of ... Appeals for the Eleventh Circuit and to the United...and one Personal Holiday each year. + State Group Insurance coverage options, including health, life, dental, vision, and… more
- Centene Corporation (Tallahassee, FL)
- …optimize outcomes. + Collaborates effectively with clinical teams, network providers, appeals team, medical and pharmacy consultants for reviewing complex cases and ... medical necessity appeals . + Participates in provider network development and new...work in the areas of Health Administration, Health Financing, Insurance , and/or Personnel Management is advantageous. Experience treating or… more
- Elevance Health (Tampa, FL)
- …and consultant to other areas of the company; particularly the Medical Review and Appeals areas + May be required to represent the company to external entities ... a state or territory of the United States when conducting utilization review or an appeals consideration and cannot be located on a US military base, vessel or any… more
- AdventHealth (Altamonte Springs, FL)
- …Advisor is an important contact for clinicians, external providers, contracted health insurance payors, and regulatory agencies. This individual also serves as the ... and making recommendations on appealed provider claims and makes determinations for appeals and grievances from patients; assists in drafting and submitting clinical… 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
- Intermountain Health (Tallahassee, FL)
- …for the accurate and timely submission of claims follow up, reconsideration and appeals , response to denials, and re-bills of insurance claims, and all ... for performing a variety of complex duties, including working outstanding insurance claims follow-up for no response, unresolved from payors, and/or claim… 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
- AdventHealth (Maitland, FL)
- …escalation to Supervisor/Manager if necessary. + Processes administrative and Medical appeals , refunds, reinstatements and rejections of insurance claims with ... Student Loan Repayment Program + Career Development + Pet Insurance **Schedule:** Full-Time **Shift** : Monday - Friday 8:00am...better. **You Will Be Responsible For:** + Works with Insurance payers to ensure proper billing takes place on… more
- MyFlorida (Bunnell, FL)
- …and judgment. Duties involve processing Medicaid HMO's, Medicare and third party/commercial insurance claims. Responsible for reviewing insurance web portals for ... duties include audits, analyzes, and reviews superbills for verification of all insurance information; makes the necessary determination as to the correct … more
- Lincoln Financial (Tallahassee, FL)
- …will independently assess more complex & higher value financial risks related to insurance products, determine price at which LFG will accept risks, alter coverage ... risk & pricing, and bind LFG in transactions for insurance products. You will determine whether to accept or...and independently with sales to address case issues and appeals , with little direction from underwriting management. * Negotiates… more