- Humana (Tallahassee, FL)
- …resolution to a pending call.** The Claims Research & Resolution Representative 2 works with insurance companies, providers, members, and collection services ... a part of our caring community and help us put health first** The Bilingual 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 II 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 (Doral, FL)
- …Insurance Collector is responsible for the timely follow-up and resolution of insurance claims . This role ensures accurate and efficient collection of ... outstanding balances from insurance payers, working to reduce aging accounts receivable and...according to departmental procedures. + Follow up on unpaid claims within payer-specific guidelines and timelines. + Coordinate with… 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
- Centene Corporation (Tallahassee, FL)
- …medical provider office, customer service within a healthcare organization, and medical claims . Knowledge of health care, managed care, Medicare or Medicaid.Pay ... up accurately in the provider information system for state reporting, claims payment, and directories. Responsible for multiple state deliverables, network reporting… more
- 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
- 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