- Zelis (St. Petersburg, FL)
- …members achieve more favorable financial outcomes. What you will do: + Analyze medical claims submitted by members along with their Explanation of Benefits ... to research claim issues and ensure accurate claim processing resolutions + Provide ongoing case follow...to Zelis: + Bachelor's Degree + 5+ years of medical claims & member benefit application experience… more
- Cognizant (Tallahassee, FL)
- …of pay interactions, appeal outcomes, and resolution activities. *Perform comprehensive follow -up on hospital claims to resolve outstanding accounts receivable. ... you will perform advanced level work related to resolution of hospital claims . You will be responsible for resolving aged hospital accounts receivables, identifying… more
- AdventHealth (Maitland, FL)
- …and Medical appeals, refunds, reinstatements and rejections of insurance claims with the oversight of the Supervisor and/or Manager Qualifications **EDUCATION ... in order to expedite resolution of accounts. + Works follow up report daily, maintaining established goal(s), and notifies...accurate billing. Processes daily error logs, stalled reports, aging claims , and any ah-hoc reports. Addresses claim … more
- Zelis (St. Petersburg, FL)
- …an advisory role with management of direct reports required. + Advanced competency in medical claim review and payment integrity preferred. + Ability to analyze ... a team of Clinician's performing clinical reviews of facility claims , including UB's, Itemized Bills and medical ...ensure savings are maximized and captured timely through proper claim handling. Effective and proven leadership experience is a… more
- Lincoln Financial (Tallahassee, FL)
- …organization. This position will be responsible for reviewing, analyzing, and interpreting medical information available for disability claims . In this role you ... a clinical resource for Group Protection benefit specialists and claim professionals. You will evaluate medical information...this role you will provide coaching and guidance to claims regarding medical management. **What you'll be… more
- Elevance Health (Tampa, FL)
- …coding or quality assurance environment preferred. + Broad knowledge of medical claims billing/payment systems provider billing guidelines, payer reimbursement ... -expense spending. The **DRG CODING AUDITOR** is responsible for auditing inpatient medical records and generating high quality recoverable claims for the… more
- UNUM (Tallahassee, FL)
- …Physical Medicine and Rehabilitation. This position is responsible for providing expert medical analysis of claims files (or underwriting applications) across ... and efficient medical consultative services to the Benefits Center. The Medical Consultant adheres to current regulatory, claim process, and internal… more
- AdventHealth (Maitland, FL)
- …between insurance and hospital. Works with Insurance payers to ensure proper follow up on billing/denials/variances takes place on all assigned patient accounts. ... notifies Director, of issues preventing achievement of such goal(s). Manages the follow up on daily correspondence to appropriately resolve patient accounts with one… more
- Cardinal Health (Tallahassee, FL)
- …Practice Operations Management oversees the business and administrative operations of a medical practice. The Revenue Cycle Management team focuses on a series of ... distributing, and managing all billable services for reimbursement to the medical facility. This role works directly with insurance companies, healthcare providers,… more
- University of Miami (Medley, FL)
- …receipts, and refers accounts to collection agencies. + Processes third-party insurance claims , requests and submits claim forms, and processes insurance ... Office has an exciting opportunity for a full-time Supervisor, Medical Collections (H) to work in Miami, FL. The...Collections (H) to work in Miami, FL. The Supervisor, Medical Collections (H) oversees staff responsible for third-party … more