- Humana (Tallahassee, FL)
- …or FSA designation, MAAA + 2+ years of actuarial experience in health insurance and/or medical claims analytics + Proficiency in data analysis and one or more ... Qualifications** + Strong communication skills + Strong working knowledge of healthcare claims as it relates to trend analytics, total cost of care management,… more
- MyFlorida (Jacksonville, FL)
- …the meaning and spelling of words, rules of composition, and grammar. + Knowledge of medical billing claims and invoice processes (2 years). + Skills related to ... records and Microsoft applications. + Must have 2 years of experience in medical billing claims and invoice processing. + Must have 1 year of Community Health… more
- Sedgwick (Tallahassee, FL)
- …, dental vision, 401K on day one. **Skills & Knowledge** + Knowledge of medical terminology + Understanding of claims management + Excellent oral and written ... Apply your knowledge and experience to adjudicate complex customer claims in the context of an energetic culture. +...PURPOSE** **:** To provide excellent service to callers regarding claims for multiple lines of business; to expedite the… more
- Molina Healthcare (Miami, FL)
- …as the professional scope of a Payment Integrity Clinician. This includes assessing medical documentation, itemized bills, and claims data to ensure appropriate ... tracking cost containment initiatives through comprehensive clinical and financial analysis of claims data, medical documentation, and itemized bills. + Leads… 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
- Norstella (Tallahassee, FL)
- …will be pivotal in integrating diverse data sources, including laboratory data, electronic medical records (EMR), claims data, and social determinants of health ... goals. + Drive the integration of diverse data sources, including lab, EMR, claims , and SDoH data, to create comprehensive and actionable datasets + Identify and… more
- CHS (Clearwater, FL)
- … claims administration, is where submissions for payment/reimbursement/sharing from medical providers and covered individuals are reviewed, subject to cost ... **Overview** ** Claims Manager** **Servicing** **Health Insurance Policies or Benefits** **Summary:** Premier Administrative Solutions (PAS) is a Third-Party… more
- City of Jacksonville (Jacksonville, FL)
- All Lines Claims Adjuster Print (https://www.governmentjobs.com/careers/jacksonvillefl/jobs/newprint/5014420) Apply All Lines Claims Adjuster Salary $66,944.85 ... Risk Management Division is actively seeking a All Lines Claims Adujuster. Did you know as a City of...and financial exposure and determines liability; obtains and reviews medical records and bills; analyzes city, state, and federal… more
- The Hartford (Lake Mary, FL)
- …regulatory and ethics requirements + Accurately and timely assess the indemnity, medical and expense exposure of assigned Specialized claims and manage ... Specialist Claims - CH07DE We're determined to make a...and Settlement Strategies, Efficient, Timely and Accurate Investigations and Medical Management are responsibilities of this position. The position… more
- Ryder System (Tallahassee, FL)
- …(http://ryder.com/job-applicant-privacy-policy) ._ **Job Description** : **Summary** The Senior Claims Representative handles complex and mid-to-high exposure bodily ... injury and property damage claims under Ryder's self-administered liability program. This position investigates...all relevant laws and regulations as well as related medical and legal terminology + Requires strong claim technical… more