- Highmark Health (Tallahassee, FL)
- …the ability to identify issues related to professional and facility provider claims data including determining appropriateness of code submission, analysis of the ... of effective Payment Integrity strategies on a pre-payment and retrospective claims review basis. Review process includes a review of medical documentation,… more
- Robert Half Management Resources (Jacksonville, FL)
- …closely with healthcare revenue cycle processes to ensure accurate medical billing and claims management. If you have experience in healthcare revenue cycles and a ... billing operations, ensuring timely and accurate processing. * Handle medical claims by reviewing, validating, and resolving discrepancies. * Collaborate with team… more
- Evolent (Tallahassee, FL)
- …fostering trust, expertise and cooperation. + Extract, manage, and analyze claims and operational data using industry-standard metrics. + Process and validate ... raw unadjudicated claims data. **Qualifications Required and Preferred:** + Bachelor's degree,...Evolent is proud to offer comprehensive benefits (including health insurance benefits) to qualifying employees. All compensation determinations are… more
- Elevance Health (Miami, FL)
- …eligible for employment based sponsorship. **Ensures accurate adjudication of claims , by translating medical policies, reimbursement policies, and clinical editing ... research and responds to system inquiries and appeals. + Conducts research of claims systems and system edits to identify adjudication issues and to audit … more
- AIG (Miami, FL)
- Make your mark in Underwriting AIG underwriting teams help to find insurance solutions in areas including Financial Lines, Property, Casualty, Specialty Lines, ... the full potential in each colleague - empowering our people to grow as insurance professionals and add more value to our customers and AIG. The AIG Facultative… more
- MyFlorida (Tallahassee, FL)
- …Disability Insurance , Supplemental Security Income and/or Medically Needy disability claims filed in the State of Florida. Training is provided on relevant ... POSSIBLE MULTI-HIRE OPPORTUNITY THIS IS AN OPS POSITION TITLE: OPS CLAIMS ADJUSTERS, EXAMINERS AND INVESTIGATORS MEDICAL DISABILITY EXAMINER POSITION LOCATION:… more
- Sedgwick (Tampa, FL)
- …Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Housing Specialist **PRIMARY PURPOSE:** Booking and extending Airbnb reservations in ... adjusters, carrier supervisors and outside contractors. + Maintains effective relationships with insurance carriers as well as across multiple lines of business and… more
- HCA Healthcare (Sarasota, FL)
- …plans (accident, critical illness, hospital indemnity), auto and home insurance , identity theft protection, legal counseling, long-term care coverage, moving ... assistance, pet insurance and more. + Free counseling services and resources...will be responsible for daily charges, preparing and submitting claims to third party payers, applying contractual adjustments, credit… more
- Humana (Tallahassee, FL)
- …provider reimbursement programs for an organization that provides health insurance . The Senior Provider Reimbursement Professional works assignments involve ... certification from the AAPC and/or AHIMA) + Extensive knowledge of medical claims processing and familiarity with reimbursement methodologies, ICD, CPT, and HCPCS +… more
- Sedgwick (Tallahassee, FL)
- …as a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Litigation Consultant | Auto | Remote **PRIMARY PURPOSE** : To address and ... Ten (10) years of experience handling litigation including 5 years of claims management experience or equivalent combination of education and experience required.… more