- Elevance Health (FL)
- …per week. The **Provider Reimburse Admin Sr** ensures accurate adjudication of claims , by translating medical policies, reimbursement policies, and clinical ... with Federal and state mandates. + Works with other departments on claims adjudication workflow development and business process improvements. + May lead the… more
- Elevance Health (Tampa, FL)
- …coordinating, monitoring, and evaluating care plans designed to optimize member health care across the care continuum. Performs duties telephonically or on-site ... make an impact** : + Ensures member access to services appropriate to their health needs. + Conducts assessments to identify individual needs and a specific care… more
- Western Digital (Tallahassee, FL)
- …leave; medical /dental/vision insurance ; life, accident and disability insurance ; tax-advantaged flexible spending and health savings accounts; employee ... and recommend appropriate courses of action. + Coordinate property and casualty insurance claims control function at all locations. + Continuous review… more
- Elevance Health (Tampa, FL)
- …procedures. + Develops and analyzes business performance reports (eg for claims data, provider data, utilization data) and provides notations of performance ... and/or Dental Vendors is strongly preferred. + Experience with 837P and 837D claims /encounters is strongly preferred. + Advanced knowledge of Excel and SQL is… more
- CVS Health (Tallahassee, FL)
- At CVS Health , we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming ... health care. As the nation's leading health ...project management experience + 5 to 7 years healthcare insurance experience + Strong analytical skills and attention to… more
- J&J Family of Companies (Palm Beach Gardens, FL)
- …to Professional Education, Communications, Legal/HCC, HR Communications. + Provide medical /surgical/scientific criteria in claims and collateral material ... articles (abstracts, manuscripts, etc), in order to support regulatory approval/clearance, health technology assessment, customer access, medical safety and… more
- Humana (Tallahassee, FL)
- …us put health first** The Corporate Medical Director (CMD) relies on medical background to review health claims and preservice appeals. The Corporate ... Qualifications** + Medical utilization management experience + Working with health insurance organizations, hospitals and other healthcare providers, patient… more
- Paychex (St. Petersburg, FL)
- …multiple Paychex products. Ensures good customer relations are maintained and customer claims and complaints are resolved fairly, effectively and in accordance with ... 2 years of call center/customer service exp + healthcare, insurance /benefit exp is preferred + Life Accident and... /benefit exp is preferred + Life Accident and Health license is required for candidates. Employees hired into… more
- Humana (Tallahassee, FL)
- …us put health first** The Corporate Medical Director relies on medical background and reviews health claims and preservice appeals. The Corporate ... + Medical utilization management experience, + working with health insurance organizations, hospitals and other healthcare providers, patient… more
- Centene Corporation (Tallahassee, FL)
- …per year Centene offers a comprehensive benefits package including: competitive pay, health insurance , 401K and stock purchase plans, tuition reimbursement, paid ... 28 million members as a clinical professional on our Medical Management/ Health Services team. Centene is a...of recommendations to providers that would improve utilization and health care quality. + Reviews claims involving… more