- 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
- Concentrix (Tallahassee, FL)
- Job Title: Customer Service Representative- Remote ( Healthcare Claims ) Job Description **JOB DESCRIPTION** The Customer Service Representative- Remote ( ... working from home, you will: + Provide customer support processing medical claims in a back-office setting...Remote ) role include: + 1+ year of previous claims experience ( healthcare claims preferred… 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 (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
- MyFlorida (Fort Lauderdale, FL)
- …and determining managed care compliance with the SMMC contract as it relates to claims processing . Examples of work include: Analyzes programmatic reports of ... plans related to compliance with contract provisions, provider reimbursement and claims processing requirements. Maintains up-to-date knowledge concerning the… more
- Humana (Tallahassee, FL)
- …JD, MSN, Clinical Certifications, CPC, CCS, CFE, AHFI). * Understanding of healthcare industry, claims processing and investigative process development. ... established guidelines/procedures. **Use your skills to make an impact** **WORK STYLE:** 100% remote /work at home. While this is a remote position, occasional… more
- Humana (Tallahassee, FL)
- …support, client services, client administration, customer service, enrollment, and eligibility, claims processing , and call center operations. Investigates and ... of customer service experience, including typing/data entry + Professional healthcare experience or education in a healthcare ...employers offering a variety of professional onsite, field, or remote based opportunities for a period up to 11… more
- Humana (Tallahassee, FL)
- …is seeking an Encounter Data Management Professional 1 that has experience with business processing and data entry to join working remote anywhere in the US. ... problems within the encounter process between Humana and CMS using data analysis, claims research, and other resources to provide insight and ensure data integrity… more
- Canon USA & Affiliates (Tallahassee, FL)
- …and review of collaterals for clinical accuracy and adherence to clinical claims . Effectively interacts with multiple teams including R&D, global and local business, ... protocol development, data acquisition, phantom studies, equipment evaluations, post processing , and development of presentations. + Provide evidence-based guidance… more
- Norstella (Tallahassee, FL)
- …(MD/DO), or a related field. + Experience working with and querying large healthcare databases, including claims , EMR/EHR, and laboratory data, in an academic ... Sr. Medical Analyst Company: MMIT Location: Remote , United States Date Posted: Jul 17, 2025...**Why MMIT?** At MMIT, we simplify the complexities of healthcare to smooth access to life saving therapies. Our… more
- Mass Markets (FL)
- …736), Business Process Management (BPM), Business Process Outsourcing (BPO), Claims Processing , Collections, Customer Experience Provider (CXP), Customer ... RESPONSIBILITIES Key responsibilities: + Provide information to customers about various healthcare options and insurance policies. + Help customers choose the… more
- Otsuka America Pharmaceutical Inc. (Tallahassee, FL)
- …engagement strategies are optimized, personalized, and aligned with the needs of healthcare professionals (HCPs) and other stakeholders. The ideal candidate is a ... or not clearly defined. + **Travel & Collaboration:** + Although this is a remote role, 30% travel for in-person meetings will be essential, including travelling to… more
- Humana (Tallahassee, FL)
- …to make an impact** **Required Qualifications** **5 years of medical claims processing /auditing or encounter data management experience** **Demonstrated deep ... to assignments. The Senior Encounter Data Management professional ensures data integrity for claims errors that result from the data exchange between Humana and its… more