• Account Manager Medicare

    AdventHealth (Maitland, FL)
    **Account Representative Manager Billing/Collections/Denials -AdventHealth** **Location Address:** **900 WINDERLEY PL, Maitland, 32751** **Top Reasons to work at ... - 5:00pm **You Will Be Responsible For:** + Manages the cohesive relationship between insurance and hospital. Works with Insurance payers to ensure proper follow… more
    AdventHealth (10/03/25)
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  • Insurance Verification…

    Surgery Care Affiliates (Tallahassee, FL)
    …for Primary insurance . + Utilize the centers selected vendor for claims and eligibility and/or individual payer websites to obtain eligibility, benefits and/or ... guidelines and the process of collecting over the counter payments/deductibles/copay/co- insurance . Knowledge of payer contracts including Medicare , Medicaid… more
    Surgery Care Affiliates (07/15/25)
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  • Representative II, Accounts Receivable

    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
    Cardinal Health (10/10/25)
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  • IRT Appeals Representative

    Humana (Tallahassee, FL)
    …of our caring community and help us put health first** The Appeals Representative 4 - IRT (Internal Review Team) Investigates and resolves member and practitioner ... to determine if an appeal or further request is warranted. The Appeals Representative 4 IRT (Internal Review Team) + Review documents + Building cases +… more
    Humana (10/10/25)
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  • REMOTE Insurance Collectors / Patient…

    Insight Global (Jacksonville, FL)
    Job Description Insight Global is seeking an Insurance Collector/Follow-up Representative to work in the Revenue Cycle department for a large regional rehab ... of insurance denials and follow-up experience * Familiar with various insurance carriers (BCBS, Tricare, Medicare , Medicaid, etc.) * Understanding of Medical… more
    Insight Global (10/04/25)
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  • Prior Authorization Technician - Remote

    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
    Polaris Pharmacy Services, LLC (10/02/25)
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  • Manager, Fraud and Waste

    Humana (Tallahassee, FL)
    …- What it takes to Succeed** + Bachelor's Degree + Minimum of 3 yrs health insurance claims or Medicare experience + Minimum 3 years of experience with ... experience directly managing a group of seasoned professionals. + Proven knowledge in Medicare regulations + Excellent PC skills MS Excel and Access and PowerPoint… more
    Humana (09/24/25)
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  • Grievances and Appeals 3

    CenterWell (Tallahassee, FL)
    …ability to read, write, and speak English and Spanish + Prior experience with Medicare + Experience with the Claims Administration System (CAS) + Knowledge of ... caring community and help us put health first** The Grievances & Appeals Representative 3 manages client denials and concerns by conducting a comprehensive analytic… more
    CenterWell (10/08/25)
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  • Collections Specialist

    HCA Healthcare (Sarasota, FL)
    …coding or billing errors from EOBs and work to correct them + You will monitor insurance claims and contact insurance companies to resolve claims + ... plans (accident, critical illness, hospital indemnity), auto and home insurance , identity theft protection, legal counseling, long-term care coverage, moving… more
    HCA Healthcare (09/19/25)
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  • Pharmacy Coordinator

    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
    Highmark Health (09/09/25)
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