- UIC Government Services and the Bowhead Family of Companies (Avon Park, FL)
- …matters relating to daily operations of the permanent site and its associated remote site locations. + Available, during scheduled hours of operations within 2 hours ... knowledge of computer systems including USAF databases, computer graphics, and word processing applications, in order to perform assigned duties. + High school… more
- Mass Markets (Tampa, FL)
- …736), Business Process Management (BPM), Business Process Outsourcing (BPO), Claims Processing , Collections, Customer Experience Provider (CXP), Customer ... services. Our contact centers are powered by both on-site and remote agents, leveraging advanced technologies to enhance customer journeys, drive scalability… more
- Molina Healthcare (FL)
- …overpayment recoveries in a managed care or payer environment. + In-depth knowledge of medical and hospital claims processing , including CPT/HCPCS, ICD, and ... requirements related to but not limited to coverage, reimbursement, and processing functions to support systems solutions development and maintenance. This role… more
- Humana (Tallahassee, FL)
- …where needed. Follows established guidelines/procedures. **KEY ACCOUNTABILITIES** + Review medical documentation, obtain additional information that may be needed ... + Maintain knowledge of TRICARE, all HGB policies and procedures as well as medical necessity review criteria and privacy requirements **Use your skills to make an… more
- NANA Regional Corporation (Panama City, FL)
- …Center, Panama City Division (NSWC PCD). This role is responsible for processing Common Access Cards (CACs), managing Department of Defense (DoD) identification ... with Homeland Security Presidential Directive 12 (HSPD12) and Federal Information Processing Standards (FIPS201-1). + Notify appropriate security personnel of any… more
- Humana (Tallahassee, FL)
- …Humana Pharmacy Solutions ensuring compliance with programmatic requirements, such as claims processing , prior authorization, formulary management and clinical ... first** The Clinical Pharmacist Lead monitors drug development pipeline, and medical literature, while providing clinical support for internal stakeholders. Utilizes… more
- Public Consulting Group (Tallahassee, FL)
- …+ Third Party Administrator Services + Enhance Health and Public Safety Services + Claims Processing Services and Solutions + Consulting and Advisory Services + ... workers for work authorization, including H-1B sponsorship** . \#LI \#LI-LR1 \#LI- remote **Compensation:** Compensation for roles at Public Consulting Group varies… more
- Guardian Life (Tallahassee, FL)
- …AI. + Apply AI/ML to unstructured data sources such as insurance contracts, medical records, sales notes, and customer service logs. + Deliver solutions that enhance ... underwriting risk assessment, claims auto-adjudication, and customer servicing. Operational Excellence + Establish scalable processes, frameworks, and governance… more
- ChenMed (Miami, FL)
- …in this role assists with the strategic alignment and oversight of claims assembly and submission processes. In close collaboration with Billing, Coding, IT, ... serves as a subject matter expert on risk-adjustment and medical economics to aid in the development of revenue...Qlik Sense and MySQL plus a variety of other word- processing , spreadsheet, database, e-mail, and presentation software + Ability… more