- Sedgwick (Tallahassee, FL)
- …new business plan with goals and objectives for assigned locations/offices; provides expert medical and product support to Sedgwick claims and clinical staff. ... Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Assistant Vice President **PRIMARY PURPOSE** : To provide strategic recommendations… more
- Humana (Tallahassee, FL)
- …skills to make an impact** **Required Qualifications** **5+ years of medical claims processing/auditing or encounter data management experience** **Demonstrated ... team leadership experience** **Demonstrated experience in managing projects effectively** ** Medical claims experience** **Additional Information** **_This position… more
- Otsuka America Pharmaceutical Inc. (Tallahassee, FL)
- …drug development programs, including: + Understanding pharmacology of drugs and unmet medical needs. + Formulating a rationale to develop the drug in accordance ... quality. + Developing and leading formal presentations of results to the medical community, in written, verbal, andvisual formats. + Analyzes and interprets the… more
- Walmart (Orlando, FL)
- …issues for example systems insurance stock processing information for thirdparty insurance claims coordinating with insurance companies to resolve ... rejections interpreting thirdparty return messages reject codes and insurance problem descriptions reprocessing thirdparty claims using the correct procedures to… more
- AON (Tampa, FL)
- … plans for PEO clients. + Analyze data such as census information, claims experience, and premium history to calculate insurance premiums. + Collaborate ... employee stock purchase plan; consideration for long-term incentive awards at Aon's discretion; medical , dental and vision insurance , various types of leaves of… more
- Orlando Utilities Commission (Orlando, FL)
- …+ Low-cost medical , dental, and vision benefits and paid life insurance premiums with no probationary period. + OUC's Hybrid Retirement Program includes a ... tools. + Experience partnering with third-party vendors, brokers, and insurance carriers to communicate, deliver, administer, and manage benefit, retirement,… more
- Walmart (Coral Springs, FL)
- …prescription fulfillment process when necessary by processing information for thirdparty insurance claims rescanning illegible images alerting patients to ... the pharmacist in the prescription fulfillment process processing third party insurance claims andor rejections assisting patientsmembers with prescription… more
- Elevance Health (Miami, FL)
- …for fraud and abuse prevention and control. + Reviews and conducts analysis of claims and medical records prior to payment and uses required systems/tools to ... Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical -expense spending. The **Clinical Provider Auditor II** is responsible for… more
- Elevance Health (Tampa, FL)
- …for fraud and abuse prevention and control. + Reviews and conducts analysis of claims and medical records prior to payment and uses required systems/tools to ... Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical -expense spending. The Clinical Provider Auditor II is responsible for… more
- Elevance Health (Miami, FL)
- …not eligible for employment based sponsorship. **Ensures accurate adjudication of claims , by translating medical policies, reimbursement policies, and clinical ... into effective and accurate reimbursement criteria.** PRIMARY DUTIES: + Review medical record documentation in support of Evaluation and Management CPT codes.… more