- AdventHealth (Altamonte Springs, FL)
- …fee schedules. Liaises with payers to address issues and ensure accurate processing . Works closely with Managed Care contract administration to ensure accurate ... provider profiles. Maintains knowledge of current rules and regulations of Commercial and Government programs. Aggregates and categorizes variance types for management review. Serves as a resource for payment variance identification and education. Coordinates… more
- CVS Health (FL)
- …and security requirements. **Required Qualifications** + 1 year minimum of claims processing experience + Experience with system testing and post go-live validation ... + QNXT Experience + Familiarity with clinical and code editing concepts and products (Example: ClaimsXten, Cotiviti PPM & CV) + Extensive knowledge of CPT, HCPCS, ICD-10 coding **Preferred Qualifications** + Prior Relevant Work Experience 3-5 years + Working… more
- AdventHealth (Tampa, FL)
- …within established timeframes. Communicates coding-related issues that may affect claims processing , coding accuracy, or compliance with the Coding Management Team. ... Assumes ownership of the discharged not final coded accounts held by monitoring the queue holds and ensuring accounts are released in a timely manner. Codes inpatient charts and verifies or assigns ICD-10-CM/PCS diagnosis and procedure codes. **The expertise… more
- Healthfirst (FL)
- …Processes claim adjustment requests following all established adjustment and claim processing guidelines. + Identifies and escalates root cause issues to supervisor ... for escalated review. + Reviews and responds independently to internally escalated provider disputes transferred by management and other associates. + Additional duties as assigned **Minimum Qualifications:** + Coding certification from either American Academy… more
- TD Bank (Fort Lauderdale, FL)
- …money laundering detection activities, review of transactions and/or other processing activities. **Depth & Scope:** + Works within established guidelines, ... accountable for completing routine transactions or low-moderate risk, repetitive processes within a standardized framework + Completes transactions using a limited number of systems and/or applications + Manages their own workload, coordinating tasks and… more
- Amcor (Miramar, FL)
- …by leveraging fact-based elements, ie supplier price breakdown, including processing cost obtained either through internal calculations, external benchmarking, ... market driven pricing, etc. to support the assigned commodity/category strategy execution to meet P+ business objectives. + Generate and maintain TCO Tools and price breakdowns for Category Managers and Strategy discussions + Assist in the definition,… more
- Highmark Health (Tallahassee, FL)
- …tasks in support of the sales process: new and renewal processing , product implementation, re-enrollment activities, vendor interaction, group set-up or ... cancellation, running reports, preparing meeting materials, developing proposals and benefit grids, research, problem resolution, and other administrative and account relationship activities. **ESSENTIAL RESPONSIBILITIES** + Effective management of work flow:… more
- Raymond James Financial, Inc. (St. Petersburg, FL)
- …and provides technical guidance when required on acquiring, organizing, protecting and processing data to fulfill business objectives. Works with full competence to ... envision and document the future state of processes and products by identifying the solution scope, potential value of the future state, and the changes to the process, products, organization infrastructure, capabilities, and technology necessary to achieve… more
- Actalent (Orlando, FL)
- …reading engineering drawings and documentation. + 3 years of related experience with processing CDRLs/SDRLs in accordance with the Contract SOW 1423s and DD250s and ... in accordance with the applicable Industry Standards. + 3 years of related experience ensuring that customer requirements are implemented and reviews change accounting activity to ensure compliance with configuration management policies. + 3 years of related… more
- Staples (Deerfield Beach, FL)
- …accounting, or economics desirable) + Excellent computer skills (database, spreadsheet, word processing , presentation) plus SQL (or similar DB) and AS400 systems & ... pricing logic We Offer: + Inclusive culture with associate-led Business Resource Groups + Flexible PTO (22 days) and Holiday Schedule (7 observed paid holidays) + Online and Retail Discounts, Company Match 401(k), Physical and Mental Health Wellness programs,… more