- AssistRx (Orlando, FL)
- …and support all operational and financial processes related to claim processing activities. In addition, manager will ensure effective day-to-day operations and ... and external business review meetings. Responsible for forecasts and analyzing claims data to determine Copay utilization, establish escrow account minimum balances… more
- Prime Therapeutics (Tallahassee, FL)
- …fuels our passion and drives every decision we make. **Job Posting Title** Lead Claims Processor, Government Programs **Job Description** Adjudicate or submit ... and adjustments as required. + Implementation and maintenance of claims processing programs and procedures + Verify...and administrative duties as required by business need. + Lead and implement positive changes with a high level… more
- CHS (Clearwater, FL)
- … claims prior to payment. * Oversight for the ongoing management of claims processing technology, including plan building and identification of new and ... the client's stated coverage. Join Premier Administrative Solutions as a Claims Manager and lead our Claims Department in delivering exceptional service to… more
- CHS (Clearwater, FL)
- …guidelines, and reporting requirements; Federal and state regulations; and timeliness of claims processing . + Utilize Excel, prepares tracking and trending ... up-to-date working knowledge on regulatory requirements associated with billing and claims processing , as well as HIPAA guidelines/established Encryption… more
- Elevance Health (Tampa, FL)
- …The **Clinical Document Improvement Director** is responsible for leading encounter processing , diagnostic documentation and claims integrity across CareBridge. ... cycle management (RCM) organizations, with specific understanding in end-to-end claims / encounter processing , as well as ensuring...is designed to advance our strategy but will also lead to personal and professional growth for our associates.… more
- USAA (Tampa, FL)
- …and implementation of multiple Data and Analytics sub-functions for Claims that may include: Information Strategy and Architecture, Information Management, ... Governance, Information Delivery Analytics & Insights Delivery, and Support. Lead the short-term and long-term strategy and vision of...and vision of the assigned sub-functions for the CoSA Claims working with peers to set objectives across the… more
- Nestle (Palm Beach Gardens, FL)
- …and nutrition for patients and consumers. **POSITION OVERVIEW:** The Customer Solutions and Claims Specialist serves as the primary point of contact for the customer ... order touches. + Identify and resolve demand capture failures to ensure timely processing . + Monitor and address account specific issues upon receipt of order;… more
- Molina Healthcare (Miami, FL)
- …test assumptions through data, but lead with contextual knowledge of claims processing , provider contracts, and operational realities. + Creates succinct ... execute effective Payment Integrity strategies through both pre-payment and post payment claims reviews, aligning with industry and corporate standards as well as… more
- Molina Healthcare (FL)
- …test assumptions through data, but lead with contextual knowledge of claims processing , provider contracts, and operational realities. + Create succinct ... and executing operational initiatives tied to Payment Integrity (PI) and provider claims accuracy. The individual will be relied upon to make independent, informed… more
- Molina Healthcare (St. Petersburg, FL)
- …test assumptions through data, but lead with contextual knowledge of claims processing , provider contracts, and operational realities. + Creates succinct ... Analysis** + Uses a business lens to ensure accurate interpretation of provider claims trends, payment integrity issues, and process gaps. + Applies understanding of… more