- 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
- Truist (Orlando, FL)
- …guidelines. 2. Independently analyze, research, and support electronic payment cases/ claims /inquiries escalated by internal departments and client service centers to ... resolution. Claims /inquiries related to Regulation E are met in accordance...shadowing. QUALIFICATIONS Required Qualifications: The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable… more
- Medtronic (Miami, FL)
- …Clinical Expert + Translates complex technical messaging, dispels competitive claims , resolves complex technical issues, and maintains customer relationships through ... within the Responsibilities section of this job description are representative of those that must be met by an...needs to perform the essential functions. + Frequent required travel to customer clinics, hospitals and offsite meetings. While… more
- RTX Corporation (Largo, FL)
- …customer communications and building a robust customer relationship + Supplier Claims /Request for Economical Adjustments (REA's) and mediation management + Conduct ... Establish Risk and Opportunities and Mitigation plans + Domestic travel up to 25% **Qualifications You Must Have** +...competitive benefits packages include: + Medical, dental, and vision insurance + Three weeks of vacation for newly hired… more
- GAP Solutions Inc (Tallahassee, FL)
- …systems. + Assisting with drafting SOP's. + Processing personal liability insurance reimbursement claims . + Initiating tentative selection notifications, notice ... calendars; + screen phone calls and assist visitors; + make travel arrangements; + coordinate conference/meeting arrangements; prepares agendas, correspondence, and… more
- RTX Corporation (Largo, FL)
- …standard provisions. + Review and advise SC on performance issues such as claims and insolvency. + Assist the organization in writing business processes, policies ... and Program Counsel on significant legal problems and issues. + Minimal domestic travel to Raytheon sites as required. **Qualifications You Must Have:** + Typically… more
- Polk County Public Schools (Bartow, FL)
- …to all services provided to students including, but not limited to, any insurance or Medicaid claims . **Non-Essential Functions of this Job** Performs other ... to perform each essential duty satisfactorily. The requirements listed are representative of the knowledge, skill and ability required. Reasonable accommodations may… more