- Elevance Health (Tampa, FL)
- …**Financial Operations Recovery Specialist** is responsible for setting up and adjusting claims overpayments that have been previously identified. May do all or some ... of the following in relation to cash receipts, cash application, claim audits, collections, overpayment vendor validation, and claim adjustments. **How you will… more
- Sedgwick (Tallahassee, FL)
- …Insurance Marine Adjuster **PRIMARY PURPOSE** **:** To investigate and process marine claims adjustments for clients; to handle complex losses locally unassisted up ... documentation, and issues settlement. + Receives and reviews new claims and maintains data integrity in the claims...+ Prepares settlement documents and requests payment for the claim and expenses. + Assists in preparing loss experience… more
- AdventHealth (Maitland, FL)
- … claims analytics Managed Care, Patient Financial services, health insurance claims processing, contract management, or medical economics Proficiency in ... (Monday, Wednesday, Thursday) on-site **The role you will contribute:** A Senior Medical Economics analyst is responsible for analyzing and evaluating financial and… more
- Elevance Health (Miami, FL)
- …not eligible for employment based sponsorship. **Ensures accurate adjudication of claims , by translating medical policies, reimbursement policies, and clinical ... into effective and accurate reimbursement criteria.** PRIMARY DUTIES: + Review medical record documentation in support of Evaluation and Management, CPT, HCPCS… more
- CVS Health (Tallahassee, FL)
- …representatives that are responsible for contacting payers to collect on unpaid claims in a timely and accurate manner, researching and resolving payment variances, ... and managing the accurate and timely filing of claims within payer function group. **Additional responsibilities of the... processing changes + Ensure daily reconciliation of electronic claim files + Maintain productivity and quality standards of… more
- Humana (Tallahassee, FL)
- …in identification of cost drivers, utilization patterns, and anomalies in Medicaid medical claims data. The Actuary, Analytics/Forecasting ensures data integrity ... community and help us put health first** Own and manage Medicaid claims analytics dataset using Databricks. Ensure data accuracy, completeness, and readiness to… more
- Sedgwick (Orlando, FL)
- …payments and/or adjustments for client paid leave plans ensuring that on-going claim management is within company service standards and industry best practices. ... and solution-focused. **ESSENTIAL RESPONSIBLITIES MAY INCLUDE** + Establishes FMLA claims ; tracks and codes documentation in accordance with internal workflow… more
- Sedgwick (Orlando, FL)
- … for multiple lines of business, including but not limited to, expediting the claims process, and providing detailed claim notes on all calls, resolving issues ... growth opportunities + A diverse and comprehensive benefits offering including medical , dental vision, 401K, PTO and more. **APPLICATION PROCESS** You will… more
- Molina Healthcare (Tampa, FL)
- …of provider reimbursement changes + Provide data driven analytics to Finance, Claims , Medical Management, Network, and other departments to enable critical ... **Job Summary** The Manager, Medical Economics provides support and consultation to the...and manage information from large data sources. + Analyze claims and other data sources to identify early signs… more
- Otsuka America Pharmaceutical Inc. (Tallahassee, FL)
- The Director, Congress and Medical Education Strategy & Execution is responsible for developing and leading the global medical strategy and tactical execution ... with global and regional cross-functional stakeholders - including Global Medical Affairs, Clinical Development, Global Integrated Evidence & Innovation (GIE&I)… more