- Humana (Tallahassee, FL)
- …a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to make ... reference materials, internal teaching conferences, and other reference sources. Medical Directors will learn Medicare, Medicaid, and Medicare Advantage requirements… more
- Elevance Health (Tampa, FL)
- …abuse prevention and control. + Review and conducts analysis of claims and medical records prior to payment . Researches new healthcare-related questions as ... **Clinical Fraud Investigator II - Registered Nurse and CPC - Calrelon Payment Integrity SIU** **Location:** This role requires associates to be in-office 1 - 2 days… more
- Centene Corporation (Tallahassee, FL)
- …involving complex, controversial, or unusual or new services in order to determine medical necessity and appropriate payment . + Develops alliances with the ... for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering… more
- Elevance Health (Tampa, FL)
- …coding or quality assurance environment preferred. + Broad knowledge of medical claims billing/ payment systems provider billing guidelines, payer reimbursement ... for employment, unless an accommodation is granted as required by law._ Carelon Payment Integrity is a proud member of the Elevance Health family of companies,… more
- Humana (Tallahassee, FL)
- …to make an impact** **Required Qualifications** + Minimum 1 year of experience in medical claims payment and processing + Minimum 1 year of experience analyzing ... and researching medical claims + Proficient in Microsoft Office (Word, Excel,...home in the state of California will be provided payment for their internet expense. + A minimum standard… more
- ICW Group (Orlando, FL)
- …be here! **PURPOSE OF THE JOB** The purpose of this job is to oversee payment recovery efforts arising out of claims payments made on ICW Group claims. This position ... **ESSENTIAL DUTIES AND RESPONSIBILITIES** Oversees activities within the Claims Payment Recovery team. + Works to improve the quality...* We offer a competitive benefits package, with generous medical , dental, and vision plans as well as 401K… more
- Elevance Health (FL)
- ** Payment Innovation Director** This role requires associates to be in-office 3 days per week, fostering collaboration and connectivity, while providing flexibility ... employment, unless an accommodation is granted as required by law. The ** Payment Innovation Director** is responsible for Payment Innovation business solution… more
- Citigroup (Tampa, FL)
- …through comprehensive payroll management, strategic cash flow optimization and robust payment capabilities controls, empowering our organization to thrive and our ... employees to succeed. Payment Controls Operations, as part of Cash Services, is...and retention awards. Citi offers competitive employee benefits, including: medical , dental & vision coverage; 401(k); life, accident, and… more
- Elevance Health (Tampa, FL)
- **Investigator Assistant - Payment Integrity SIU** **Location:** This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and ... for employment, unless an accommodation is granted as required by law._ **Carelon Payment Integrity** is a proud member of the Elevance Health family of companies,… more
- Elevance Health (Tampa, FL)
- **Investigator I - Payment Integrity SIU** **Location:** This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, ... for employment, unless an accommodation is granted as required by law._ **Carelon Payment Integrity** is a proud member of the Elevance Health family of companies,… more