• Claims Research

    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
    Humana (11/09/24)
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  • Call Center Representative [Full Time]

    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
    CHS (11/16/24)
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  • Bilingual Call Center Representative

    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
    Mass Markets (10/16/24)
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  • Sr Construction Representative

    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
    HNTB (11/12/24)
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  • Care Management Associate - Must Reside in

    CVS Health (Tallahassee, FL)
    …regarding confidentiality. -Create authorizations, outreach providers, bridge service gaps, assist with claims resolution and monitor authorization & claims ... Utilizes Dynamo, QNXT and other Aetna systems to build, research and enter member information, as needed. - Assists...as a medical assistant, office assistant or member services representative or equivalent experience + Candidate must reside in… more
    CVS Health (11/23/24)
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  • Program Management Program Engineer

    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
    MyFlorida (11/14/24)
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  • Reimbursement Coordinator

    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
    Cardinal Health (11/20/24)
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  • Financial Services Technician (Title 5)

    Army National Guard Units (St. Augustine, FL)
    …regulations, precedent decisions, and procedures to determine appropriate action for resolution . Perform research regarding many different and unrelated ... unit and eligible for labor organization representation. The current exclusive representative is The Association of Civilian Technicians, Chapter 87 and the… more
    Army National Guard Units (11/17/24)
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  • Case Manager

    Cardinal Health (Tallahassee, FL)
    …needs of the patient and/or program + Resolve patient's questions and any representative for the patient's concerns regarding status of their request for assistance ... based upon region and ensure proper communication of the resolution within required time frame agreed upon by the...region with the appropriate team + As needed conduct research associated with issues regarding the payer, physician's office,… more
    Cardinal Health (11/02/24)
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  • Case Manager

    Cardinal Health (Tallahassee, FL)
    …needs of the patient and/or program * Resolve patient's questions and any representative for the patient's concerns regarding status of their request for assistance ... based upon region and ensure proper communication of the resolution within required time frame agreed upon by the...region with the appropriate team * As needed conduct research associated with issues regarding the payer, physician's office,… more
    Cardinal Health (09/24/24)
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