- Elevance Health (Miami, FL)
- …with fraud and abuse. **How you will make an impact:** + Examines claims for compliance with relevant billing and processing guidelines and identifies opportunities ... fraud and abuse prevention and control. + Reviews and conducts analysis of claims and medical records prior to payment and uses required systems/tools to accurately… more
- Elevance Health (Tampa, FL)
- …with fraud and abuse. **How you will make an impact:** + Examines claims for compliance with relevant billing and processing guidelines and identifies opportunities ... fraud and abuse prevention and control. + Reviews and conducts analysis of claims and medical records prior to payment and uses required systems/tools to accurately… 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
- Elevance Health (Tampa, FL)
- …I** is responsible for accurate and timely maintenance of provider information on claims and provider databases. **How You Will Make an Impact** Primary duties may ... but are not limited to: + Assists in synchronization of data among multiple claims systems and application of business rules as they apply to each database. +… more
- USAA (Tampa, FL)
- …P&C Claims Operations and/or Optimization experience. + 2+ years of MCO ( Manager , Claims Operations) experience. + Deep operational knowledge of end-to-end ... claims processes. + Demonstrated knowledge of new and emerging...comprehensive medical, dental and vision plans, 401(k), pension, life insurance , parental benefits, adoption assistance, paid time off program… more
- ChenMed (Greenacres, FL)
- …needed to maintain workflow and meet/ complete deadlines as assigned by the Pharmacy Manager or Pharmacist on duty. + Processes claims for 3rd party ... drugs. + Maintains knowledge of asset protection techniques, creates claims for order errors and damaged goods. + Maintains...reimbursement efficiently and correctly to third-party insurance providers to obtain payment. + Earns and maintains… more
- TD Bank (Jacksonville, FL)
- …delinquency and avoid default or adverse action + Assists Customers in processing insurance claims and requests for contractual rebates + May initiate processing ... and trustees to challenge bankruptcy if appropriate + Processes and collects insurance claims and refundable contract premiums including primary insurance… more
- TD Bank (Jacksonville, FL)
- …Identifies reasons why customers can or cannot pay + Assists customers in processing insurance claims and requests for contractual rebates + Reviews accounts for ... and executing bidding strategies + May process and collect insurance claims and refundable contract premiums including...have regular career, development, and performance conversations with your manager , as well as access to an online learning… more
- HCA Healthcare (Jacksonville, FL)
- …coding or billing errors from EOBs and work to correct them + You will monitor insurance claims and contact insurance companies to resolve claims + ... plans (accident, critical illness, hospital indemnity), auto and home insurance , identity theft protection, legal counseling, long-term care coverage, moving… more
- HCA Healthcare (Sarasota, FL)
- …coding or billing errors from EOBs and work to correct them + You will monitor insurance claims and contact insurance companies to resolve claims + ... plans (accident, critical illness, hospital indemnity), auto and home insurance , identity theft protection, legal counseling, long-term care coverage, moving… more