- Acosta Group (Tampa, FL)
- **DESCRIPTION** This position will be responsible for processing and handling any claims that are incomplete or escalated for validation. This person will also be ... responsible for analyzing claims and making decisions about their validity. The position..., assesses the reason for the escalation, and provides resolution in priority order as directed by the Supervisor.… more
- Molina Healthcare (St. Petersburg, FL)
- …with appropriate departments, develops and tracks remediation plans, and monitors claims reprocessing through resolution . Interprets and presents in-depth ... **Job Description** **Job Summary** Serves as claims subject matter expert. Assist the business teams...subject matter expert. Assist the business teams with reviewing claims to ensure regulatory requirements are appropriately applied. Manages… more
- Molina Healthcare (St. Petersburg, FL)
- …accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims databases. Synchronizes ... claim payment system and other applicable systems. + Participates in defect resolution for assigned component + Assists with development of configuration standards… more
- Molina Healthcare (St. Petersburg, FL)
- …organizational and technical challenges. Performs research and analysis of healthcare claims data, pharmacy data, and external data to derive proper courses ... and requests, utilizing technical tools as necessary to provide feedback and resolution within the Service Level Agreement. + Assist with research, development and… more
- Molina Healthcare (St. Petersburg, FL)
- **JOB DESCRIPTION** **Job Summary** Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization and ... ensuring the highest quality on every project/request. Responsible for error resolution , follow up and performance metrics monitoring. + Provides peer review… more
- MUFG (Tampa, FL)
- …/Money Market inquiries as well as cases requiring compensation payments and/or claims in accordance with established regulations. Ensuring all cases are verified in ... + Able to utilize internal & external resources required for the timely resolution of assigned cases. + Maintain thorough and accurate records, facilitating unit… more
- HUB International (Tampa, FL)
- …service and claim representatives) and client contacts. + Confidentially assist with all claims matters and bring to resolution with proper documentation and ... a liaison between the client and insurance carriers for service, enrollment, claims and administration; constantly maintaining quality and service standards as it… more