- Humana (Tampa, FL)
- …part of our caring community and help us put health first** The Claims Research & Resolution Representative 3 manages claims operations, assisting in ... processing of corrected claims . The Claims Research & Resolution Representative 3 performs advanced administrative / operational / customer support… more
- Humana (Tampa, FL)
- …part of our caring community and help us put health first** The Claims Research & Resolution Representative 2 manages claims operations that involve ... independent initiative and judgment. Tampa Office The Claims Research & Resolution Representative 2 + Works with ancillary departments, providers,… more
- CHS (Clearwater, FL)
- …mandate a high level of service, including telephone service, accuracy, call resolution and satisfaction. TheMember and Provider Service Representative (MPSR) is ... **Overview** ** ** **Call Center Representative | Member and Provider Services Representative...Supervisor. + For any calls or correspondence where additional research is necessary, clearly explaining to the caller the… more
- Mass Markets (Tampa, FL)
- …Listen to customers, understand their needs, and resolve customer issues + Research systems to find missing information as applicable; coordinate with other ... account management tasks + Accurately document and process customer claims in appropriate systems + Follow all required scripts,...customer issues to the appropriate staff and managerial for resolution as needed. + Ensure first call resolution… more
- HNTB (Miami, FL)
- …but not limited to; assists change manager and project manager in contractor claims and disputes. Tracks, reviews and processed RFIs and submittals and performs ... on work progress and construction problems, proactively recommends solutions, assists in the resolution of issues, and acts as a liaison with the engineer of record.… more
- Publix (Lakeland, FL)
- …operates, and + Associate of Risk Management designation or Certified Claims Representative Designation. **Zip Code:** 33811-3311 **Benefits Information:** + ... applicable laws and regulations. + Oversee the handling and resolution of claims to minimize legal risks...ensure effective and efficient legal support. + Conduct legal research and analysis to support decision-making and policy development.… more
- MyFlorida (Tallahassee, FL)
- …Performs a wide variety of administrative tasks involving independent analysis, research and judgment in areas of administrative duties supporting Tallahassee and ... Orlando Claims Processing operations. Develop and maintain a comprehensive database...as liaison with People First in regard to problem resolution . Is knowledgeable and current on statutes, rules, regulations,… more
- HealthEdge Software Inc (Tallahassee, FL)
- …issues are identified and addressed upstream, and all aspects of claims operations are centralized for comprehensive business intelligence. The complete suite ... as escalation point for critical client needs aswarranted. + Lead diagnosis and resolution of escalated and more involved/complex client problems and issues. + Act… more
- CVS Health (Tallahassee, FL)
- …regarding confidentiality. -Create authorizations, outreach providers, bridge service gaps, assist with claims resolution and monitor authorization & claims ... by the State. - Utilizes Dynamo, QNXT and other Aetna systems to build, research and enter member information, as needed. - Assists Case Managers with coordination… more
- MyFlorida (Kissimmee, FL)
- …in accordance with Department procedures. Ensure detailed review, analysis, and resolution of consultant/contractor issues, supplemental agreements, claims , and ... Central Office, Federal Highway Administration (FHWA), and State Materials and Research Office on technical matters relating to Design/Construction and continual… more
- Cardinal Health (Tallahassee, FL)
- …pharmacy insurance benefit practices, preferred * 1-2 years of Pharmacy and/or Medical Claims billing and Coding work experience * 1-2 years' experience with Prior ... patient/physician inquiries and concerns in a timely manner * Mediate effective resolution for complex payer/pharmacy issues toward a positive outcome to de-escalate… more
- FirstBank PR (Miami, FL)
- …to regulatory requirements (6) Daily batch payment processing Handle and analyze claims and complaint management system for loan servicing including: (1) Conduct ... research to resolve loan requests and issues, (2) Communicates...(2) Communicates with internal and external customers to provide resolution , (3) Ensure proper analysis of root causes of… more