- Elevance Health (Tampa, FL)
- …experience preferred. + Broad knowledge of clinical documentation improvement guidelines, medical claims billing and payment systems, provider billing ... claims . **How you will make an impact:** + Analyzes and audits claims by integrating medical chart coding principles, clinical guidelines, and objectivity in… more
- L3Harris (Melbourne, FL)
- …Friday off Job Description: We are looking for a labor and employment law specialist to join our centralized Global Labor & Employment practice group, reporting to ... and Immigration. Essential Functions: + Investigate, negotiate and resolve pre-litigation claims and administrative charges to drive results consistent with the… more
- MyFlorida (St. Petersburg, FL)
- …to be used for consistent application of criteria. + Liaisons with specialist providers requesting additional medical information as needed. INDIRECT SERVICES ... Specialty Care Program, whose primary functions are to generate medical referrals for specialists in the Pinellas County Health...a timely manner. + Enter services and process billing claims . + Enters Services and tracking process for Directions… more
- Banner Health (FL)
- …you. **Requirements:** + **5 years recent experience in acute-care Inpatient facility-based medical coding (clearly reflected in your attached resume);** + **DRG and ... researching authoritative reference information from a variety of sources. 2. Reviews medical records. Performs an audit of clinical documentation to ensure that… more
- Kemper (Doral, FL)
- …Basic and/or Analytics Academies are desirable. + Certified Insurance Fraud Analyst (CIFA), Fraud Claims Law Specialist (FCLS) or Fraud Claims Law Associate ... College Degree or equivalent work experience * Three years of insurance claims experience or related fraud analytics background. **Position Requirements:** + Strong… more
- Molina Healthcare (Tampa, FL)
- …the likelihood of a formal appeal being submitted. + Independently re-evaluates medical claims and associated records by applying advanced clinical knowledge, ... programs supported by the plan such as Utilization Review, Medical Claims Review, Long Term Service and...+ Active and unrestricted Certified Clinical Coder + Certified Medical Audit Specialist + Certified Case Manager… more
- Mass Markets (FL)
- …partner in the industry. We are seeking a Licensed Life and Health Insurance Specialist who will play a vital role in educating and guiding customers to select ... and retention. + Respond to customer inquiries regarding coverage, benefits, claims , and other insurance-related questions. + Maintain accurate and up-to-date… more
- NTT America, Inc. (Tallahassee, FL)
- …and the corporate insurance group as regards to high value insurance claims , to ensure that documentary information has been collected, secured, and preserved ... so that claims will be resolved in a timely manner as...+ Certified Safety Professional (CSP) or Certified Safety Management Specialist (CSMS) preferred. + Certified Environmental Professional CHMM and… more
- AssistRx (Maitland, FL)
- …from the Specialty Pharmacies + Relays status updates and challenges to Program Specialist as appropriate + Provide support as needed in managing cases escalated ... reimbursement issues by working closely with Specialty Pharmacies, and Program Specialist . Job Details Snapshot: + Compensation: $22-25/hr + Location(s): 495 N.… more
- Molina Healthcare (St. Petersburg, FL)
- …activities with other departments in Molina including Finance, Revenue analytics, Claims and Encounters, and Medical Directors + Maintains professional ... administrative duties such as planning, scheduling of chart reviews, obtaining of medical records, and provider training and education + Assists in coordinating… more