- CDM Smith (Sarasota, FL)
- …expertise may be needed throughout the program delivery process. * Supports the claims process by reviewing and validating damage details, scopes of work, and costs ... by providing updates on work status and may evaluate claims and make recommendations to FEMA as to whether...and make recommendations to FEMA as to whether the claim is eligible. Assists with the development of the… more
- MUFG (Tampa, FL)
- …US compliance regulation checks/screening/data entry; and (h) acceptances/payments, Reimbursement claims . To assist the Section in achieving its planned objectives, ... Laws)/FEFTA /Red flags/vessels/shipping lines/ports/country violations relating to trade finance documents/ claims /transactions. **Transaction Processing in Trade 360 System** : Prepare… more
- MUFG (Tampa, FL)
- …US compliance regulation checks/screening/data entry; and (c) acceptances/payments, Reimbursement claims . To assist the Section in achieving its planned objectives, ... Laws) /Red flags/vessels/shipping lines/ports/country violations relating to trade finance documents/ claims /transactions. **Transaction Processing in Trade 360 System** : Prepare… more
- Trinity Health (Fort Lauderdale, FL)
- …charging processes and audits, and clinical billing. Strong understanding of various medical claim formats. + Knowledge of clinical documentation improvement ... M-F, 8a-5p remote position that requires certification. For the Holy Cross Medical Group this individual performs charge entry, charge approvals, and/or quality… more
- CVS Health (Tallahassee, FL)
- …and business partners in Africa,. This role supports the international network, medical cost management, and overall claim /customer service experience. The ... Network manager in ensuring service level adherence (GOP TAT, eligibility processing, claim TAT, reconciliation TAT, fee invoicing etc) + Ensure TPA networks are… more
- CVS Health (Tallahassee, FL)
- …**Position Summary** The Negotiator Analyst is responsible for negotiating out-of-network (OON) medical claims valued at $10,000 and above. This role involves ... are developed. **Required Qualifications** + 3-5 years of experience in a medical claim background with understanding of benchmarking costs for medical … more
- Highmark Health (Tallahassee, FL)
- …related internal, concurrent, prospective and retrospective coding audit activities. Reviews medical records to determine data quality and accuracy of coding, ... and ensures compliance with DRG/APC structure and regulatory requirements. Performs periodic claim form reviews to check code transfer accuracy from the abstracting… more
- Intermountain Health (Tallahassee, FL)
- …Requirements* Workflow Process* Communication* Insurance Processing and Issues* Medical Terminology* Claims Processing* Collaboration* Time Management* ... Workflow Process + Communication + Insurance Processing and Issues + Medical Terminology + Claims Processing + Collaboration + Time Management + Team Building… more
- AdventHealth (Maitland, FL)
- …as it relates to reimbursement methodologies + Applies significant understanding of medical coding systems affecting the adjudication of claims to include ... damages calculations, and organizing data/materials from other AdventHealth departments (ie medical records, itemized bills, etc.) within the scheduled timeframes. +… more
- Elevance Health (Tampa, FL)
- …Cost of Care and/or Provider Contracting organizations. Focuses efforts on lowering claims costs, improving the quality of care, and increasing member and provider ... works with one provider type, eg physician, ancillary, or medical group. Provides advice and analytic support to ...and specialty care procedures and recommends policy changes and claim 's system changes to pursue cost savings. + Reviews… more