- Guidehouse (Tampa, FL)
- …edits such as: + Correct Coding Initiatives (CCI) + Medically Unlikely Edits (MUE) + Medical Necessity edits + Other claim level edits as assigned + As needed, ... third party payer accounts that are subject to pre-bill claim edits, hospital billing scrubber bill hold edits, and...and reporting requirements including resolution of CCI, MUE and Medical Necessity edits applied to claims . +… more
- HCA Healthcare (Tampa, FL)
- …you want to join an organization that invests in you as a Collections Legal Specialist ? At Parallon, you come first. HCA Healthcare has committed up to $300 million ... colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no...a difference. We are looking for a dedicated Legal Specialist like you to be a part of our… more
- HCA Healthcare (Pensacola, FL)
- …integrity. We care like family! Jump-start your career as a(an) Billing Specialist today with HCA Florida West Cardiology Specialists. **Benefits** **HCA Florida ... colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no...by location._** Come join our team as a(an) Billing Specialist . We care for our community! Just last year,… more
- Allied Universal (Tallahassee, FL)
- …files associated with the program + Assist with the workers' compensation claims management by issuing and obtaining claim paperwork, collecting statements, ... communities and customers we serve. Allied Universal(R) is hiring a Branch Support Specialist . The Branch Support Specialist is responsible for being the primary… more
- Sedgwick (Tallahassee, FL)
- …Fortune Best Workplaces in Financial Services & Insurance (Remote) EDI Support Specialist - Casualty **PRIMARY PURPOSE** **:** To identify, research, resolve, and ... of related experience to include two (2) years of workers' compensation or claims related experience and three (3) years of EDI technical experience including… more
- Centene Corporation (Tallahassee, FL)
- … medical provider office, customer service within a healthcare organization, and medical claims . Knowledge of health care, managed care, Medicare or ... up accurately in the provider information system for state reporting, claims payment, and directories. Responsible for multiple state deliverables, network reporting… more
- Sedgwick (Tallahassee, FL)
- …Work(R) Fortune Best Workplaces in Financial Services & Insurance ADA Accommodation Specialist **PRIMARY PURPOSE** : To enhance the ADA process for claimants ... requesting accommodations under the ADAAA; to review complex medical information for temporary and permanent accommodation requests; and to approve and/or negotiate… more
- Molina Healthcare (Orlando, FL)
- …to reduce the likelihood of a formal appeal being submitted. * Reevaluates medical claims and associated records independently by applying advanced clinical ... in the specific programs supported by the plan such as utilization review, medical claims review, long-term services and supports (LTSS), or other specific… more
- Molina Healthcare (Tampa, FL)
- …and prepares written response to incoming provider reconsideration request is relating to claims payment and requests for claim adjustments or to requests from ... to ensure that internal and/or regulatory timelines are met. + Research claims appeals and grievances using support systems to determine appeal and grievance… more
- CDM Smith (West Palm Beach, FL)
- …40509BR **Business Unit:** FSU **Job Description:** The Disaster Program Delivery Specialist : * Collects, coordinates and/or reviews applicant data to determine ... needed throughout the program delivery process. * Supports the claims process by reviewing and validating damage details, scopes...and make recommendations to FEMA as to whether the claim is eligible. Assists with the development of the… more