- Humana (Tallahassee, FL)
- …resolution to a pending call.** The Claims Research & Resolution Representative 2 works with insurance companies, providers, members, and collection services ... **Become a part of our caring community and help us put health first** The Claims Research & Resolution Representative 2 manages claims operations that… more
- Humana (Tallahassee, FL)
- …community and help us put health first** The Consumer Service Operations Representative 3 is responsible for the daily activities across multiple service functions ... area. The Consumer Service Operations Representative 3 performs advanced administrative/operational/customer support duties that require independent initiative and… more
- Cardinal Health (Doral, FL)
- …the right things done. **The Accounts Receivable Specialist is responsible for processing insurance claims and billing. They will work within the scope of ... from AR & Billing leadership teams.** **_Responsibilities_** + Processes claims : investigates insurance claims ; and...or third party policy. + Updates patient files for insurance information, Medicare status, and other changes… more
- Molina Healthcare (Miami, FL)
- …to, phone, chat, email, and off phone work supporting our Medicaid, Medicare and/or Marketplace business. Also provides product and service information, identifies ... for a wide variety of inquiries and assistance involving their benefits, claims , premiums, and other areas including very complex issues. Conducts initial research… more
- Fresenius Medical Center (Jacksonville, FL)
- …coordinate insurance options: + Educates on the availability of alternative insurance options (ie, Medicare , Medicaid, Medicare Supplement, State Renal ... and annual indigent waivers. + Discusses insurance options when insurance contracts are terminated. Responsibilities involving Medicare and Medicaid include… more
- Polaris Pharmacy Services, LLC (Fort Lauderdale, FL)
- …analyze and appropriately resolve rejected claims by working with national Medicare D plans, third party insurance companies, and all state Medicaid ... for managing and identifying a portfolio of rejected pharmacy claims to ensure maximum payer reimbursement and timely billing...environment PHYSICAL DEMANDS The physical demands described here are representative of those that should be met by an… more
- Highmark Health (Tallahassee, FL)
- …medication requests, and drug claim edits/prior authorizations. By reviewing member claims history, clearly defines the medical necessity of non-formulary and prior ... of benefit billing practices through paid clams review. + Participate as pharmacy representative in onsite member appeals and grievances sessions. + Serve as a… more
- Lake Erie College of Osteopathic Medicine (Defuniak Springs, FL)
- …with responsibility for protocols that will aid patients in the reimbursement of insurance claims ; + Assist in the recruitment, interviewing, and hiring of ... understanding of dealing with and processing Florida Medicaid and Medicare ; + Possess a strong sense of patient advocacy,...experience; + Faculty member will commit to being a representative of LECOM by being actively involved in the… more