- AdventHealth (Maitland, FL)
- …value you will bring to the team:** NEGOTIATION (20%) Represents AdventHealth as lead negotiator for assigned top-tier and mid-level tier managed care health plans ... care issues by collecting and interpreting contract performance information (eg claims volumes, quality and efficiency reports, participation gap analysis, accounts… more
- Trinity Health (Fort Lauderdale, FL)
- …and HCPCS level II coding guidelines, along with CCI edits and Medicare claims processing manual contents in a multi-facility, integrated health care delivery ... way of thinking and perceiving our world and that these differences often lead to innovative solutions. Our dedication to diversity includes a unified workforce… more
- Intermountain Health (Tallahassee, FL)
- …Diabetes (SUPD). A key focus of this role is to design, implement, and lead targeted projects that support improvements in CMS Star Ratings and member health ... + Pharmacy + Pharmacy Benefits Management (PBM) + Medical Prescriptions + Pharmacy Claims + Customer Service + Problem Resolution + Phone Calls (Inbound/Outbound) +… more
- National Express (Jacksonville, FL)
- …located throughout North America. Learn more at nellc.com. **Responsibilities:** + Lead , design, develop and implement initial and recurrent training programs for ... events to ensure excellence in customer service. + Ability to Investigate claims and incidents of questionable conduct, accidents etc. + Computer literacy skills… more
- MyFlorida (Tallahassee, FL)
- …The Administrative Assistant I (AAI) works under the direct supervision of the Lead Administrative Assistant III (AAIII) with assistance from the Chief Attorney and ... the General Counsel. Your Specific Responsibilities: + Assists attorneys by processing cases, including preparing administrative complaints, motions, and orders for… more
- Prime Therapeutics (Tallahassee, FL)
- …those that may be in use in a Pharmacy Benefit Management setting ( Claims Processing , Prior Authorization, Telephony, Membership, etc.). + Consideration will be ... tools, such as self-service capabilities and standard report packages. May lead efforts to create curriculum to improve user adoption. + Ensures… more
- Molina Healthcare (FL)
- …conducts research to resolve customer initiated issues related to core systems processing , and coordinates and manages project teams in the development of large ... Prepare and design test plans and test cases with the help of testing lead for both new and existing features (regression testing). + Vendor Management: Provides… more
- Walgreens (Tampa, FL)
- …enhancements to pharmacy systems to further promote productivity. + Ensures the accurate processing of insurance claims to resolve customer issues and prevent ... has more than 21,000 stores. WBA's purpose is to help people across the world lead healthier and happier lives. The company is proud of its contributions to healthy… more
- Sysco (Pompano Beach, FL)
- …+ Assist in resolving any system issues which may arise in daily load processing . + Monitor carrier and system status messages and mitigate any expected inbound ... delivery impacts. + Communicate daily with Director of Transportation, Claims Coordinator, and Transportation Supervisors, Transportation Leads, and Transportation… more
- University of Miami (Miami, FL)
- …+ Responds to customer inquiries regarding insurance coverage of services and processing of claims . + Follows appropriate procedures to link alternative ... HMO payers and refers to proper managing department. + Serves as a lead Insurance Verification Representative and assists in training new staff. + Adheres to… more