- Molina Healthcare (St. Petersburg, FL)
- JOB DESCRIPTION Job Summary Provides support for claims recovery activities including researching claim payment and billing guidelines, audit results, and ... Standard Operating Procedures (SOPs). * Responds to provider correspondence related to claims recovery requests and provider remittances where recovery … more
- Sedgwick (Tampa, FL)
- …Fortune Best Workplaces in Financial Services & Insurance Sr. Claims Specialist | Medical Malpractice (PL) | Remote , Florida **PRIMARY PURPOSE** **:** ... To analyze complex or technically difficult medical malpractice claims ; to provide resolution of highly complex nature and/or severe injury claims ; to coordinate… more
- Molina Healthcare (St. Petersburg, FL)
- …review to facilitate a referral to law enforcement or for payment recovery . **KNOWLEDGE/SKILLS/ABILITIES** + Reviews post pay claims with corresponding medical ... records to determine accuracy of claims payments. + Review of applicable policies, CPT guidelines,...+ AAPC Certified Medical CPC, CPMA, CPCO or similar specialist preferred + Certified Fraud Examiner and/or AHFI professional… more