- AdventHealth (Maitland, FL)
- …+ Facilitate resolution to contract violations by leveraging knowledge of state Insurance and Managed Care laws and state reporting requirements for HMO/ Insurance ... understanding of medical coding systems affecting the adjudication of claims to include ICD-9/10, CPT, HCPCS II, DRG and...+ 3 years Healthcare, Managed Care, Hospital or Ancillary claims analysis, Hospital or Ancillary claims payment,… more
- Cognizant (Tallahassee, FL)
- …Interpret paper contracts for reimbursement. . Troubleshoot and remediate/workaround for claim pend issues. . QNXT Configuration for New implementation and existing ... groups, fee tables, policy admin, etc. . Troubleshoot and remediate/workaround for claim pend issues. . QNXT and NetworX Configuration for different State… more
- CVS Health (Tallahassee, FL)
- …supports the international network, medical cost management, and overall claim /customer service experience. The candidate will provide concierge-level service to ... Network manager in ensuring service level adherence (GOP TAT, eligibility processing, claim TAT, reconciliation TAT, fee invoicing etc) + Ensure TPA networks are… more
- University of Miami (Medley, FL)
- …maintains cash receipts, and refers accounts to collection agencies. + Processes third-party insurance claims , requests and submits claim forms, and ... accurate records and control reports. + Advises upper management of any insurance denial trends to identify problems with particular payors. + Sends follow-up… more
- Compass Group, North America (Tampa, FL)
- …**Job Summary** The **Safety Manager** will be responsible for reducing claims and lost time injuries by providing safety and workers compensation ... annual reports. + Monitors and reports on workers' compensation claim trends and develop strategies that address injury management....benefits.** + Medical + Dental + Vision + Life Insurance / AD + Disability Insurance + Retirement… more
- AdventHealth (Maitland, FL)
- … for all provider types Managed Care, Patient Financial services, health insurance claims processing, contract management, or medical economics experience ... sources using knowledge of healthcare managed care contracts and healthcare administrative claims data Reviews existing complex models and implements them on new… more
- Arlington Toyota (Jacksonville, FL)
- …* Experience: At least 2-5 years of experience in collision estimating, automotive repair, or insurance claims , preferably in an auto body shop or insurance ... to vehicles following accidents or collisions, preparing detailed reports for insurance purposes, and helping customers understand their repair options. The ideal… more
- Zurich NA (Tallahassee, FL)
- …experience in the Claims or Underwriting Support areaOR + Zurich Certified Insurance Apprentice including an Associate Degree and 1 or more years of experience ... experience in the Claims or Underwriting Support areaOR + Zurich Certified Insurance Apprentice including an Associate Degree and 3 or more years of experience… more
- University of Miami (Medley, FL)
- …received for all pertinent information: patient demographic information, guarantor and insurance information, place of service, referrals, claim info record, ... keep the contents at a minimum. + Verifies all claims and ensures edits are collected and released in...and managed care authorization requirements. + Runs insurance eligibility and fixes registration issues. + Manually enters… more
- CVS Health (Tallahassee, FL)
- …measuring and monitoring the quality and effectiveness of work processes in claim processing and customer service that impact customer satisfaction, medical cost ... processes, and responsibilities. **Required Qualifications** + 2+ years of health insurance work experience and/or Healthcare Insurance Quality Review +… more