- CHS (Clearwater, FL)
- …**Essential Duties and Responsibilities:** + Participating as a member of the Member and Provider Services Department Management Team, including strategy, budgeting, ... staffing projection and quality improvement. + Creating a culture within the Team of exceptional service to members and their providers, as well as transparency in reporting results, trends and issues to Senior Management and clients. + On an ongoing basis,… more
- CHS (Clearwater, FL)
- …**Essential Duties and Responsibilities:** + In accordance with company guidelines, performs random medical audits, target audits, re-audits, etc and audits for ... claims which are in excess of payment authority limits in assigned audit queues. + Listen to and view all recorded customer service calls within the MPS call center. + Ensures compliance with appropriate company policies, procedures, guidelines, and reporting… more
- CHS (Clearwater, FL)
- …Essential Duties and Responsibilities: - Compiles and analyzes financial information to prepare entries to accounts, such as general ledger accounts, documenting ... **Overview** Insurance Senior Accountant Join us and enjoy a robust benefits package designed to support your well-being! (Some plans vary by state.) Full Time employees can enjoy: - Health Coverage: Two flexible medical plans. - Dental & Vision: Comprehensive… more
- CHS (Clearwater, FL)
- …**Essential Duties and Responsibilities:** + Participating as a valued MPS Team member, including active participation in Team meetings where questions, issues are ... strategies for improving the Team's service results are discussed. + Promoting a culture within the Team of exceptional service to members and their providers, as well as transparency in discussion of issues and concerns with the Team Supervisor and Department… more
- CHS (Clearwater, FL)
- …**Essential Duties and Responsibilities:** * Participating actively as a key member of the PAS' Management Team, including demonstrating leadership through strong ... communications skills, use of business metrics to determine strategy and resource needs, and showing a high level of focus on continual quality improvement. * Coordination of all activities of the Claims Department Management Team. This includes Supervisors… more
- CHS (Clearwater, FL)
- …**Summary:** The Medical Claims Examiner adjudicates medical claims based on health policy provisions and established guidelines. **Essential Duties and ... Responsibilities:** + Reviews and adjudicates medical claims based on health policy provisions and established guidelines + Requests additional information from members and providers as needed + Initiates and completes claim investigations when indicated… more