- AdventHealth (Maitland, FL)
- … for all provider types Managed Care, Patient Financial services, health insurance claims processing , contract management, or medical economics experience ... language as it relates to reimbursement methodologies Applies detailed understanding of medical coding systems affecting the adjudication of claims to include… more
- Humana (Tallahassee, FL)
- …**Use your skills to make an impact** **Required Qualifications** **5+ years of medical claims processing /auditing or encounter data management experience** ... team leadership experience** **Demonstrated experience in managing projects effectively** ** Medical claims experience** **Additional Information** **_This position… more
- Truist (Orlando, FL)
- …guidelines. 2. Independently analyze, research, and support electronic payment cases/ claims /inquiries escalated by internal departments and client service centers to ... resolution. Claims /inquiries related to Regulation E are met in accordance...tools. 9. Support extended hours for same day wire processing for all channels. 10. Under minimal supervision, perform… more
- CVS Health (Tallahassee, FL)
- …experience with complaints and/or Center for Medicare and Medicaid Services (CMS) + Medical /RX claim processing knowledge + Bachelors Degree **Education:** ... queue of Medicare complaints. These complaints can include various issues ranging from claims that are adjudicated incorrectly to rude customer service. You will be… more
- Humana (Tallahassee, FL)
- …skills to make an impact** **Required Qualifications** + Minimum 1 year of experience in medical claims payment and processing + Minimum 1 year of experience ... cross functional teams and support analyzing business processes, error processing , issues and ticket creations with the product management...analyzing and researching medical claims + Proficient in Microsoft Office… more
- City of Jacksonville (Jacksonville, FL)
- …of workers' compensation laws, rules, and regulations and workers' compensation claims processing practices and procedures with substantial litigation experience ... laws, rules, and regulations. + Knowledge of complex workers' compensation claims processing practices and procedures involving lost time, disability,… more
- Humana (Tallahassee, FL)
- …a specified time frame. + CAS, MedHOK experience strongly preferred + Previous experience processing medical claims **Required Work Schedule** **This is a ... your life extends outside of work. Among our benefits, Humana provides medical , dental and vision benefits, 401(k) retirement savings plan, time off (including… more
- MyFlorida (Tallahassee, FL)
- …Abilities: * Experience in auditing, data analysis, or fraud detection. * Knowledge of claims processing and medical terminology. * Experience in creating, ... design and implement algorithms to effectively data-mine within various types of claims data utilizing a variety of software applications; compile research, data… more
- Molina Healthcare (Miami, FL)
- …and test assumptions through data, but lead with contextual knowledge of claims processing , provider contracts, and operational realities. + Creates succinct ... as the professional scope of a Payment Integrity Clinician. This includes assessing medical documentation, itemized bills, and claims data to ensure appropriate… more
- City of Coral Gables, FL (Coral Gables, FL)
- …statutory time frames. Act as primary liaison among injured employees, managers, medical providers, and insurance representatives. Monitor claim status, reserve ... Track certificates of insurance and contractual insurance requirements. Assist with the processing of liability insurance claims . Performs other related tasks as… more