- NTT DATA North America (Orlando, FL)
- NTT DATA is seeking to hire a ** Remote Claims Processing Associate** to work for our end client and their team. **In this Role the candidate will be ... fee schedule **Requirements:** + 1-3 year(s) hands-on experience in Healthcare Claims Processing + 2+...be able to work 7am - 4 pm CST online/ remote (training is required on-camera). **Preferred Skills & Experiences:**… more
- Molina Healthcare (FL)
- …experience. **Required Experience** * 7 years' experience in healthcare claims review and/or Provider appeals and grievance processing /resolution, including ... Medicare standards and requirements related to non-contracted provider dispute/appeals processing . * Establishes member and non-contracted provider grievance/dispute and… more
- IQVIA (Miami, FL)
- **Patient Support Medical Claims Processing Representative** _Contract Remote Role - Location (Open to Remote US)_ As the only global provider of ... remote (work from home-WFH) contact **Patient Support Medical Claims Processing Representative** to join our team....good for IQVIA, our clients, and the advancement of healthcare everywhere. This role will be a contract role… more
- Elevance Health (Tampa, FL)
- …The **Clinical Document Improvement Director** is responsible for leading encounter processing , diagnostic documentation and claims integrity across CareBridge. ... The ideal candidate has experience working in leading healthcare payer claims / revenue cycle management (RCM) organizations, with specific understanding in… more
- Molina Healthcare (Jacksonville, FL)
- …operations (utilization management, disease management, HEDIS quality measures, claims processing , etc.) + Knowledge of healthcare financial terms (eg, PMPM, ... related to cost, utilization and revenue for multiple Molina Healthcare products. Designs and develops reports to monitor health...and manage information from large data sources. + Analyze claims and other data sources to identify early signs… more
- Molina Healthcare (St. Petersburg, FL)
- …DESCRIPTION** **Highly qualified candidates will have the following experience-** + Knowledge of claims / claims processing . + Experience working within ... average to expert level in Agile, Jira, PowerPoint, Excel + Understanding of who claims vendors are and what they do. Experience engaging vendors and ensuring the… more
- Molina Healthcare (Miami, FL)
- …contracts, pricing configuration, claim adjudication or reimbursement processes + Experience processing or reviewing facility claims + Prior professional ... health plan representatives, and other business teams involved in claim processing . Maintains expertise in all forms of reimbursement methodologies including fee… more
- Molina Healthcare (Orlando, FL)
- …solutions + Advanced knowledge of health care benefits. + Advanced knowledge of healthcare claims and claim processing from receipt through encounter ... including accurate and timely implementation and maintenance of critical information on claims databases. Validate data to be housed on databases and ensure… more
- Molina Healthcare (Tampa, FL)
- …party administrators. + Performs enrollment functions to include call tracking, claims workflow, and encounter requests for verification and updates, PCP assignment ... to assist peers and leadership team. + Strong knowledge of Enrollment processing for Federal, State, and business regulatory requirements with a strong system… more
- Actalent (Orlando, FL)
- … team. In this role, you will be responsible for handling insurance claims , processing prior authorizations, and making coverage determinations. You'll work ... Remote Pharmacy Technician - Insurance & Coverage Determination...Key Responsibilities + Process and follow up on insurance claims and prior authorizations + Evaluate and make coverage… more
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