- Mass Markets (FL)
- …736), Business Process Management (BPM), Business Process Outsourcing (BPO), Claims Processing, Collections, Customer Experience Provider (CXP), Customer Service, ... Schedule Options BonusYes EducationHigh School Diploma/GED Min. Years Experience0 Company/BrandMCI Location : LocationUS-FL- Remote Career LevelEntry-Level Employment TypeFull-Time Reports… more
- Molina Healthcare (Orlando, FL)
- …software and medical record vendors, and other Molina departments, such as Claims , Enrollment, IT etc,. to get appropriate responses and manage contracts and ... + Maximizes use of information from multiple sources, including claims /encounters, pharmacy, utilization management, clinical indicators, industry benchmark, and/or… more
- CVS Health (Tallahassee, FL)
- …data, user feedback, and market research to enhance digital self-service, claims transparency, provider search, member portals, and mobile applications. + Identify ... regulated industry. + Strong knowledge of healthcare payer operations ( claims , eligibility, enrollment, prior authorization, provider networks). + Experience working… more
- Molina Healthcare (Miami, FL)
- …and timely validation and maintenance of critical provider information on all claims and provider databases. Staff ensure adherence to business and system ... not limited to, Configuration, Business Systems, Encounters (inbound and outbound), Claims , Provider Services and Contracting. * Identifies issues, resolves problems… more
- UNUM (Tallahassee, FL)
- …Rehabilitation. This position is responsible for providing expert medical analysis of claims files (or underwriting applications) across Unum US product lines. The ... and internal workflow standards as set forth in the Benefits Center Claims Manual, underwriting manual, and associated documentation. The incumbent adheres to… more
- Molina Healthcare (FL)
- …or team leadership experience + 10 years' work experience preferable in claims processing environment and/or healthcare environment + Strong knowledge of SQL ... 2005/2008 SSRS and Power BI report development + Familiar with relational database concepts, and SDLC concepts **Preferred Education** + Masters' Degree in Finance, Economics, Math, Computer Science, Information Systems, or related field. + Preferred… more
- Option Care Health (Tallahassee, FL)
- …on invoices submitted to ensure prompt and timely payment. Calls to verify that claims submitted were received and are in processing. Sends letters to the patient or ... responsible party when their insurance carrier fails to make payment reasonable time frame. Generates and mails statements and collections letters. Follows-up on all denials within 48 hours of receipt. + Ensures compliance with policies and guidelines outlined… more
- AdventHealth (Tampa, FL)
- …Physician Advisor is responsible for providing clinical review of utilization, claims management, and quality assurance related to inpatient care, outpatient ... care/observation stays and referral services. The Physician Advisor is an important contact for clinicians, external providers, contracted health insurance payors, and regulatory agencies. This individual also serves as the subject matter expert, providing… more
- Molina Healthcare (Orlando, FL)
- …+ SQL expertise + Excel expertise + Medicare, Medicaid, Marketplace claims expertise **PHYSICAL DEMANDS:** Working environment is generally favorable and lighting ... and temperature are adequate. Work is generally performed in an office environment in which there is only minimal exposure to unpleasant and/or hazardous working conditions. Must have the ability to sit for long periods. Reasonable accommodations may be made… more
- Insight Global (Jacksonville, FL)
- …protocol by accurately assessing and correcting issues regarding medical necessity, claims denials, bundling issues and charge capture. - Efficiently uses available ... reference and coding tools and third party payer resources to research, maintain knowledge and provide feedback to department. - Eligible compensation range $25-$35 depending on experience. We are a company committed to creating diverse and inclusive… more