- LogixHealth (Dania, FL)
- Location: On-Site in Dania, FL This Role: As a Claims Specialist, you will work with internal teams to provide cutting-edge solutions that will directly improve the ... and carry out processes on all out of network claims . The ideal candidate will have strong technological skills,...two years related experience + Healthcare industry knowledge + Medical billing experience Benefits at LogixHealth: We offer a… 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**...Examiner queues waiting to be adjudicated, and in either audit or needing approval status. * Developing and implementing… more
- CHS (Clearwater, FL)
- … and Call Auditor (Call Center QC) - Clearwater, FL** ** ** **Summary** The Claims & Call Auditor audits processed medical insurance claims and customer ... Duties and Responsibilities:** + In accordance with company guidelines, performs random medical audits, target audits, re-audits, etc and audits for claims … more
- Cardinal Health (Tallahassee, FL)
- … medical terminology; E/M rules, teaching physician guidelines, and/or medical necessity defense reviews; healthcare compliance audit methodology, principles ... detection and correction of documentation, coding, and billing errors and/or medical necessity of services billed. Particular areas of focus include: evaluation… more
- Sedgwick (Tallahassee, FL)
- …management reports and takes appropriate action. + Performs quality review on claims in compliance with audit requirements, service contract requirements, and ... Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Team Lead I Workers Comp (Calif Exp) **PRIMARY...benefits package is offered including but not limited to, medical , dental, vision, 401k and matching, PTO, disability and… more
- Sedgwick (Tallahassee, FL)
- …management reports and takes appropriate action. + Performs quality review on claims in compliance with audit requirements, service contract requirements and ... a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Team Lead, General Liability **PRIMARY PURPOSE** : To supervise a team of… more
- Molina Healthcare (St. Petersburg, FL)
- …Data Validation) team, assisting in the execution of CMS and internal audit activities. This position contributes to the development of chart retrieval chase ... lists by helping identify and validate source data required for medical record collection. This is an ideal opportunity for an early-career analyst with a strong… more
- CRC Insurance Services, Inc. (FL)
- …5. Train claims staff on new policies or procedures. 6. Oversee and audit claims process ensuring proper documentation was created in the system and/or ... Responsible for overseeing, managing and supporting all activities of the claims employees and operations of the department. **ESSENTIAL DUTIES AND… more
- CRC Insurance Services, Inc. (FL)
- …(United States of America) **Please review the following job description:** Process claims , which includes evaluating policy for coverage; working with the insured, ... adjusters, agents and attorneys on the claim and coordinating the payment of claims . In addition, prepare reports such as loss runs and monthly bordereau.… more
- USAA (Tampa, FL)
- …and Lean, business operations, risk management, quality assurance and control, or internal audit (in addition to the minimum years of experience required) may be ... their physical, financial, and emotional wellness. These benefits include comprehensive medical , dental and vision plans, 401(k), pension, life insurance, parental… more