- Veterans Affairs, Veterans Health Administration (Daytona Beach, FL)
- …and intensive case management to a panel of patients with complex chronic medical conditions managed under PCMM guidelines to reduce recurrent ED visits and hospital ... are not limited to: Manages chronic conditions, evaluate and treat inter-current medical conditions. Determine medical assessment and develop treatment plans… more
- CVS Health (Largo, FL)
- …subject matter expert and trusted advisor. + **Issue Escalation & Follow -up:** Collaborate cross-functionally with internal teams (Eligibility, Claims , Clinical) ... in-person support across multiple worksites, handling complex benefit and claims inquiries, and providing education during open enrollment and health-related… more
- Polaris Pharmacy Services, LLC (Fort Lauderdale, FL)
- …is responsible for managing and identifying a portfolio of rejected pharmacy claims to ensure maximum payer reimbursement and timely billing to eliminate financial ... + Manage and identify a portfolio of rejected pharmacy claims to ensure maximum payer reimbursement and timely billing...for processing + Perform other tasks as assigned. + Follow all applicable government regulations, including HIPAA + Comply… more
- Datavant (Tallahassee, FL)
- …Radiology Cardiology Injection and Infusion services Orthopedics Post-operative pain blocks Medical necessity documentation Claim edits and revenue codes ... Radiology Cardiology Injection and Infusion services Orthopedics Post-operative pain blocks Medical necessity documentation Claim edits and revenue codes… more
- Intermountain Health (Tallahassee, FL)
- …**Essential Functions** + Oversees the day-to-day revenue cycle functions including claims processing, denials, payments, customer service, and follow up ... Process + Communication + Insurance Processing and Issues + Medical Terminology + Claims Processing + Collaboration...personnel to ensure fairness. We protect your privacy and follow strict data protection rules. Your information is safe… more
- HCA Healthcare (Jacksonville, FL)
- …and retirement of our colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no cost or for a low ... as well as free telemedicine services and free AirMed medical transportation. + Additional options for dental and vision...the company's mission, vision, and values by completing the follow -up and collection from third party payers and self… more
- CenterWell (Tallahassee, FL)
- …+ Know and continually review medication brand and generic names, medical terminology, and pharmaceutical calculations. + Medication adherence outreach, auditing, ... + Assist clinical pharmacists in troubleshooting prescription third party claim rejections by accessing and understanding formulary restrictions, plan limitations,… more
- Sumitomo Pharma (Tallahassee, FL)
- …(https://c212.net/c/link/?t=0&l=en&o=4190475-1&h=3440496098&u=https%3A%2F%2Fwww.us.sumitomo-pharma.com%2F&a=https%3A%2F%2Fwww.us.sumitomo-pharma.com+) or follow us ... company's new and established programs. This position reports to the Chief Medical Officer. **Job Duties and Responsibilities** + Strategic thought partner including… more
- Intermountain Health (Tallahassee, FL)
- …an overall goal of account resolution. + Abel to navigate various payer claim portals and understand payer functionality. + Interacting with others by effectively ... English. **Skills** + Recognizing true overpayments from false credits + Researching claim cycle + Understanding Coordination of Benefits + Understanding EOB +… more
- Elevance Health (Miami, FL)
- …as single point of service support (eg, phone and e-mail inquiries, claims , enrollment, billing) to Elite Broker contacts (Brokers, General Agents, Agencies, etc.) ... plan offerings, have issues that are impacting multiple service areas such as claims , eligibility, etc. and provide onsite support as needed) with timely and… more