- Elevance Health (Tampa, FL)
- …coordinating, monitoring, and evaluating care plans designed to optimize member health care across the care continuum. Performs duties telephonically. **How you ... will make an impact:** + Ensures member access to services appropriate to their health needs. + Conducts assessments to identify individual needs and a specific care… more
- Elevance Health (Tampa, FL)
- …of systems capabilities and business operations is strongly preferred. + Claims Processing, Medical Coding, Overpayment Concepts experience strongly preferred ... + Facets and/or MACESS experience preferred Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement… more
- Elevance Health (Tampa, FL)
- …implementing, coordinating, monitoring, and evaluating care plans designed to optimize member health care across the care continuum. **How you will make an impact:** ... for discharge planning. + Ensures member access to services appropriate to their health needs. Conducts assessments to identify individual needs and a specific care… more
- CVS Health (Tallahassee, FL)
- …+ Experience designing AI solutions for healthcare settings such as pharmacies, health insurance , or clinical workflows. + Background in process improvement ... At CVS Health , we're building a world of health...of AI-driven solutions to optimize healthcare processes, such as claims processing, patient care coordination, pharmacy operations, and supply… more
- System One (Deland, FL)
- …eligible employees health and welfare benefits coverage options including medical , dental, vision, spending accounts, life insurance , voluntary plans, as ... all unpaid or underpaid system debit balances on Medicare insurance claims ; Actions include but are not... health and welfare benefits coverage options including medical , dental, vision, spending accounts, life insurance ,… more
- DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
- …experience. + Minimum 3 years of related experience in an acute care or health insurance environment. + Minimum 2 years of experience with pre-authorization, ... MCG(R) screening criteria. Responsibilities: + Manages appropriate cases that require medical necessity review such as home care, elective inpatient and outpatient… more
- CVS Health (Tallahassee, FL)
- …partners. **Required Qualifications** : * 1-2 Years of applicable medical insurance experience: brokers (producers), carriers, third-party administrators, ... At CVS Health , we're building a world of health...placement of stop loss policies, negotiating terms based upon claims data, strategy, relationships. and cost avoidance/reduction efforts. *… more
- Kemper (Doral, FL)
- …and professionally negotiate settlements with claimants and attorneys. + Adjust insurance policies for UM/UIM claims . Position Qualifications: + Minimum ... and resolve moderate to severe, including fatal, bodily injury claims with prompt review and respond to all demands,...time limit demands. + Obtain and thoroughly analyze complex medical records and data. + Research and apply applicable… more
- CVS Health (Tallahassee, FL)
- …**Preferred Qualifications** + Experience working in a call center environment + Medical terminology/ insurance experience + Results oriented and self motivated + ... At CVS Health , we're building a world of health...+ Handle incoming calls from members and providers regarding claims status, benefits and eligibility, PPO participation, etc +… more
- Sedgwick (Tallahassee, FL)
- … medical , dental, vision, 401k and matching, PTO, disability and life insurance , employee assistance, flexible spending or health savings account, and other ... a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Remote Return to Work Representative Bilingual French, Hindi, Bengali or more **We… more