- Sedgwick (Tampa, FL)
- …Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Estimate Review Consultant **PRIMARY PURPOSE:** To review all estimates and ... the justified services. + Monitors, assists, tracks, and provides approval for all claims that are re-inspected by the carrier. + Maintains contact with the client… more
- MyFlorida (Miami, FL)
- …conveyance documents. Responsible for representation in defense of the Department in claims of inverse condemnation, as assigned. The Difference You Will Make: ... documents. Responsible for representation in defense of the Department in claims of inverse condemnation, as assigned. Responsible for thoroughly researching all… more
- Guidehouse (Tampa, FL)
- …plan when needed + Responsible for the daily resolution of assigned claims with applicable Revenue Integrity pre-bill edits and/or specific Revenue Integrity Hold ... and associated coding modifiers. + Responsible for daily resolution of assigned claims with Revenue Integrity specific denials in the Guidehouse METRIX℠ system. +… more
- Humana (Tallahassee, FL)
- …2 ensures contract compliance and performs analysis regarding pharmacy claims . Understands department, segment, and organizational strategy and operating objectives, ... 2 ensures contract compliance and performs analysis regarding pharmacy claims . Understands department, segment, and organizational strategy and operating objectives,… more
- MyFlorida (Kissimmee, FL)
- …General Engineering (GEC) contracts, management of the Plans and Claims Review contract, Disadvantaged Business Enterprise (DBE) program, Affirmative Action/Equal ... be addressed by all the various departments to eliminate claims impacts relating to utilities, Maintenance of Traffic Phasing,...highly competitive set of employee benefits including: + Health insurance (over 90% employer paid) + $25,000 life … more
- Humana (Tallahassee, FL)
- …and help us put health first** The Medical Coding Auditor reviews medical claims submitted against medical records provided, to ensure correct coding guidelines are ... Office, ER, Telehealth, Home Health, and minor procedures + Experience with the Claims Life Cycle + Experience with coding/auditing Professional Inpatient Claims … more
- Sedgwick (Miami, FL)
- …and experience required to include five (5) years project management, claims operation management, managed care, insurance -related and/or statistical analysis ... a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance AVP Strategy **PRIMARY PURPOSE** **:** To develop and manage strategic project… more
- Highmark Health (Tallahassee, FL)
- …with a general understanding of data flows from various corporate systems (eg, claims , billing, lab, and Rx), to solve complex issues and problems. A comprehensive ... agencies. These studies and projects may involve all aspects of the health insurance business and care management processes and may be confidential in nature or… more
- Sedgwick (Tallahassee, FL)
- …as a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance VP Client Services | Carrier, Captive, MGA | Remote We are seeking candidates ... Account Executive experience on national accounts and five (5) years claims /supervisory experience. **Skills & Knowledge** + In-depth understanding of workers… more
- HCA Healthcare (Kissimmee, 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...and Qualifications** **POSITION SUMMARY: Responsibilities include risk/CMS data management, claims management, education components of the facility's risk management… more