- Guidehouse (Tampa, FL)
- …payer UB-04 billing and reporting requirements including resolution of CCI, MUE and Medical Necessity edits applied to claims . + Proficiency in determining ... needed + Responsible for the daily resolution of assigned claims with applicable Revenue Integrity pre-bill edits and/or specific...Coding Initiatives (CCI) + Medically Unlikely Edits (MUE) + Medical Necessity edits + Other claim level edits as… more
- Western Digital (Tallahassee, FL)
- …**Job Description** **Position Summary** We are looking for a **Retail Compliance Specialist ** to join the Western Digital Fulfillment Operations Team to be ... chargebacks, late deliveries, labeling errors, incorrect shipments. Review and validate claims received from retail partners to determine legitimacy and compliance… more
- Dentsply Sirona (Sarasota, FL)
- …offering including dental and oral health products as well as other consumable medical devices under a strong portfolio of world class brands. Dentsply Sirona's ... is near the Sarasota, FL location.** **Job Summary:** **The Senior Regulatory Specialist is a contributing member of cross-functional teams in support of regulatory… more
- Elevance Health (Miami, FL)
- … Specialist ** is responsible for reviewing, auditing, and coding medical records for the purpose of reimbursement, training, education and compliance. ... Code (CPC or CCS-P) required. **Preferred Skills, Capabilities, and Experiences:** + Claims processing experience preferred. + Knowledge of medical terminology… more
- Molina Healthcare (FL)
- JOB DESCRIPTION Job Summary Provides entry level support for claims activities including reviewing and resolving member and provider complaints, and communicating ... information system and prepares documentation for further review. * Researches claims issues utilizing systems and other available resources. * Assures timeliness… more
- US Physical Therapy (Sanford, FL)
- …grow with us! **Job Description** We are seeking a detail-oriented **Insurance Verifications Specialist ** to join our team in Sanford, United States. In this role, ... + Verify patient insurance coverage, benefits, and eligibility prior to medical services + Communicate effectively with insurance providers, patients, and healthcare… more
- AssistRx (Maitland, FL)
- …coverage provided for a specific pharmaceutical product. The Patient Access Specialist will support the healthcare providers addressing questions regarding coding ... access + Document and initiate prior authorization process and claims appeals + Report any reimbursement trends or delays...patients Requirements + In-depth understanding and experience with Major Medical & Pharmacy Benefit Coverage + 2 to 3… more
- Collins Aerospace (Seminole, FL)
- …Heritage Raytheon programs Collins Aerospace is seeking a talented and driven Principal Specialist Material Program Manager (MPM) to join our Mission Systems team in ... customer communications and building a robust customer relationship + Supplier Claims /Request for Economical Adjustments (REA's) and mediation management + Conduct… more
- AssistRx (Maitland, FL)
- …provided for a specific pharmaceutical product. The Insurance Verification Specialist will support the healthcare providers addressing questions regarding coding ... access + Document and initiate prior authorization process and claims appeals + Report any reimbursement trends or delays...In-depth understanding and experience with Buy & Bill, Major Medical & Pharmacy Benefit Coverage. + 2 to 5… more
- CVS Health (Tallahassee, FL)
- …each and every day. **Position Summary** The **Senior Accounts Receivable Specialist ** prepares accounting and financial records and reports, including general ... monthly invoices in accounting system. + Enter and process monthly fee claims for ancillary product offerings via claim system. **Required Qualifications** + 2+… more