- CVS Health (Tallahassee, FL)
- …a Regional Pharmacy Onsite Auditor, you will be an essential part to the Pharmacy Audit Department at CVS/Caremark. In this role, you will be based from your home ... and travel onsite to conduct claims audits at pharmacies throughout multiple states by reviewing...our competitive wages, our great benefits include: + **Affordable medical plan options,** a **401(k) plan** (including matching company… 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
- 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**...as transparency in reporting results, trends and issues to Senior Management and clients. * Management of relationships with… more
- Otsuka America Pharmaceutical Inc. (Tallahassee, FL)
- **Position Summary** The Senior Manager, Fleet & Samples Operations oversees the execution of field fleet logistics and pharmaceutical sample distribution. The role ... day to day operations and issue resolution. Escalate issues as appropriate to senior management. + Proactively source and develop ideas to improve fleet program,… more
- The Cigna Group (Tampa, FL)
- …the requirements of business and reporting teams within areas such as pharmacy claims , medical claims , membership eligibility, etc. Build automated solutions ... _The job profile for this position is Software Engineering Senior Advisor which is a Band 4 Career Track...for data quality checks, Audit Balance and Controls (ABC), and monitoring processes. Develop… more
- Mass Markets (Tampa, FL)
- …such as quality assurance, training, IT, and recruiting. + Develop and audit quality assurance strategies to ensure the delivery of world-class service + ... sometimes even cars! + Health Benefits: Full-time employees are eligible for comprehensive medical , dental, and vision coverage after 90 days of employment, and all… more
- Wolters Kluwer (Tampa, FL)
- …platforms. In addition, during heavy periods of incoming invoice volume, conduct the initial audit and/or quality assurance invoice review audit up to 15% of the ... performance metrics using customer lens to provide upwards recommendation to management, senior leadership, and customers on how to improve customer experience +… more
- Humana (Tallahassee, FL)
- …inquiries. + Has 6-7 direct reports including Associate Directors, Managers, and Senior Professionals + Provides strategic direction and leadership to the various ... operational goals, including regulatory compliance requirements + Promotes and builds an " Audit Ready Every Day" culture + Further simplifies and improves processes… more
- Ascension Health (Jacksonville, FL)
- **Details** + **Department:** Ascension Medical Group + **Schedule:** Full-Time, Days Mon. - Fri. 8AM-5PM + **Hospital:** Ascension St. Vincent's + **Location:** ... the time of the offer._ **Responsibilities** Perform periodic and ongoing audits of claims to ensure accuracy of coding and billing, and sufficiency of supporting… more
- Citigroup (Tampa, FL)
- Serves as a senior function/business/product compliance risk manager for US Personal Banking Operations - Core Operations Independent Compliance Risk Management ... service areas. The five servicing divisions are Account Services, Claims & Cards Maintenance, Fulfillment Operations, Transaction Processing and Financial… more