- Molina Healthcare (Miami, FL)
- …the Medicaid and Medicare programs as well as Marketplace. + Understanding of claim billing codes, medical terminology, anatomy, and health care delivery ... health care fraud, waste, and abuse. Duties include performing accurate and reliable medical review audits that may also include coding and billing reviews. The SIU… more
- ZOLL Medical Corporation (Miami, FL)
- …geography is receiving the appropriate level of service with regard to ZOLL's medical devices with minimal disruption.Manage the follow -up process by working ... innovative technologies that make a meaningful difference in people's lives. Our medical devices, software and related services are used worldwide to diagnose and… more
- National Health Transport (Miami, FL)
- Summary: Ambulance Medical Billing Specialist is responsible for billing and collection processes for National Health Transport's ambulance trips. Ambulance ... Medical Billing Specialist answers inquiries from insurance companies, patients,...Specialist answers inquiries from insurance companies, patients, and processes claims accordingly. Essential duties and responsibilities: + Promotes, develops,… 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 ... network satisfaction. Provides expert advice, analytic and consultative support to Medical Directors and management on cost of care issues. Supports large scale… more
- Elevance Health (Lake Mary, 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 ... + Provides expert advice, analytic and consultative support to Medical Directors and management on cost of care issues....impact decision making tools + Recommends policy changes and claim 's system changes to pursue cost savings. + Reviews… more
- Molina Healthcare (Tampa, FL)
- …fraud, abuse, and over utilization by providers and recipients. The position will review claims data, medical records, and billing data from all types of ... the Medicaid and Medicare programs as well as Marketplace + Understanding of claim billing codes, medical terminology, anatomy, and health care delivery systems… more
- Intermountain Health (Tallahassee, FL)
- …Integrity Analyst II is responsible for appropriate charge capture, assigned account, claim edits and/or charge edits for an assigned service line. This position ... + Audits and evaluates system automation by comparing the charge/ claim data to the clinical record. Leverages other system...certification through AAPC, AHIMA or HFMA, or other specialty medical coding group. + Experience in a role requiring… more
- HUB International (Fort Myers, FL)
- …organization. We offer: + Competitive salaries and benefits offerings + Medical /dental/vision insurance and voluntary insurance options + Health Savings Account ... to communicate with other team members and assist advisor to ensure timely follow -up on group and individual renewal dates. Regularly maintain and follow -up… more
- Walgreens (Niceville, FL)
- …companies and medical providers and participates in 3rd-party audit. + Follow -up with medical providers' offices to clarify prescribed medications, dosages, ... privacy, generics, less expensive medicines, over-the-counter products, and refers to medical provider as needed to ensure medication is taken correctly, health… more
- Elevance Health (Miami, FL)
- …to conduct extensive research and analyze the grievance and appeal issue(s) and pertinent claims and medical records to either approve or summarize and route to ... + Demonstrated business writing proficiency, understanding of provider networks, the medical management process, claims process, the company's internal business… more