- HCA Healthcare (Sarasota, FL)
- …and retirement of our colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no cost or for a low ... as well as free telemedicine services and free AirMed medical transportation. + Additional options for dental and vision...work to correct them + You will monitor insurance claims and contact insurance companies to resolve claims… more
- Datavant (Tallahassee, FL)
- …+ Experience in the following fields would be beneficial: Data Entry, Medical Records, Health Care, Insurance Claims Processing and Proof Reading/Editing ... role will be performed Remote - WFH + Processing medical records along with by taking calls from patients,...related telephone calls and inquiries accurately and timely. + Review , research, resolve and respond to inquiries that are… more
- Elevance Health (Tampa, FL)
- …and abuse prevention and control. + Review and conducts analysis of claims and medical records prior to payment. Researches new healthcare-related questions ... Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical -expense spending. The **Clinical Fraud Investigator II** is responsible for… more
- CVS Health (Tallahassee, FL)
- …R, Alteryx, Trifacta, Linux OS, GCP/ AWS/ Azure. + Experience working with medical and/or pharmacy claims data. + Experience in healthcare industry, including ... a collaborative, close-knit team on pharmacy and member specific claims data including, but not limited to, financial and...Responsibilities** + Develop reports in SQL and SAS. + Review MCO/Client Requests with internal and external partners to… more
- Humana (Tallahassee, FL)
- …health care fraud investigations ( Medical Coding or Healthcare ( Medical Chart Review /Insurance Billing) or Internal/External Audit or Regulatory/Compliance ... Certifications, CPC, CCS, CFE, AHFI). * Understanding of healthcare industry, claims processing and investigative process development. * Experience in a corporate… more
- University of Miami (Miami, FL)
- …or staff position using the Career worklet, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . The Human ... sessions for the client. * Performs benefits administration to include claims resolution, change reporting, approving invoices for payment, and communicating benefit… more
- Highmark Health (Tallahassee, FL)
- …dose and duration edits, quantity limits, step-care edits, generic sampling medical policy review and development, member facing outreach initiatives ... and stakeholders across the organization. Key responsibilities will include clinical review , assisting in navigating a complex regulatory environment, working with … more
- Walgreens (Tampa, FL)
- …as immunizations. Responsible for ensuring the proper compounding, dispensation, review and verification of prescribed medications within regulatory guidelines, ... privacy, generics, less expensive medicines, over-the-counter products, and refers to medical provider as needed to ensure medication is taken correctly, health… more
- Walgreens (Pinecrest, FL)
- …as immunizations. Responsible for ensuring the proper compounding, dispensation, review and verification of prescribed medications within regulatory guidelines, ... privacy, generics, less expensive medicines, over-the-counter products, and refers to medical provider as needed to ensure medication is taken correctly, health… more
- Walgreens (Lynn Haven, FL)
- …outcomes services. Responsible for ensuring the proper compounding, dispensation, review , and verification of prescribed medications within regulatory guidelines, ... privacy, generics, less expensive medicines, over-the-counter products, and refers to medical provider as needed to ensure medication is taken correctly, health… more