Claims Review Specialist jobs in Tarpon Springs, FL

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Utilization Management Specialist
Review Utilization Management submissions for accuracy and thoroughness based on company guidelines. Communicate external and internal concerns effectively with...
Recovery/Subrogation Specialist
SECOND LOOK INC - 6 reviews - Palm Harbor, FL
Arbitration, claims handling:. Guide claims through process, diary and conducts reviews of losses to determine potential for each claim....
Desired Experience: Driver's License
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Sr. Claims Specialist / Commercial
Cameron Craig Group - 2 reviews - Tampa, FL 33646
$75,000 - $85,000 a year
Claims Specialist / Commercial. Also looking for Commercial Property Claims Specialists as well. Analyze and evaluate claims exposure, reserving all exposures...
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Claims & Denials Specialist

DAS Health - 5 reviews - Tampa, FL
Prepare, review and send patient statements. Prepare claims appeals and overturn denials as necessary. Prepare and submit clean claims to insurance companies...
Desired Experience: Bilingual, Time Management, Office Experience, Medical Terminology
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Technical Claims Specialist

Zenith American - 74 reviews - Tampa, FL 33607 (Carver City area)
Title:Technical Claims Specialist Department:. Responsible for the accurate review, input and adjudication of claims using established payment policies and...
Desired Experience: Microsoft Word, Benefits Administration, CPT-4, 10 Key Calculator
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University of South Florida Health - 81 reviews - Tampa, FL
Reviews assigned accounts, determines appropriate action to resolve outstanding balances. Responsible for prompt and accurate submission and follow-up of all...
Desired Experience: Epic

Claims Coding Specialist

WellCare - 913 reviews - Tampa, FL 33634
Preferred 1 year of experience in claims coding Candidate Skills:. Identifies and escalates root cause issues to supervisor for escalated review....
Desired Experience: SharePoint, EMR Systems, Medical Terminology, Medical Coding Certification, CPT-4

Claims Operations Support Specialist

WellCare - 913 reviews - Tampa, FL 33634
The ideal candidate will have a claims background of at least 2 years and can translate claims process impacts/changes into tasks, to drive business...
Desired Experience: Microsoft Word, Microsoft Powerpoint, SQL, Excel, Managed Care

Utilization Management Specialist

Liberty Mutual - 2,509 reviews - Tampa, FL
$32,400 - $39,600 a year
Review Utilization Management submissions for accuracy and thoroughness based on company guidelines. Communicate external and internal concerns effectively with...

Claims - Casualty Specialist II

Acceptance Insurance - 192 reviews - Tampa, FL 33614
Assess actual damages associated with claims and conduct negotiations to settle claims. Assigned claims may involve routine to more complex soft tissue injuries...
Desired Experience: Time Management, Microsoft Office

Economic Self Sufficiency Specialist I

The State of Florida - 974 reviews - Largo, FL 33778   +1 location
$23,886 a year
Economic Self Sufficiency Specialist I. Equivalent experience where the major responsibility was conducting interviews, recruiting, determining eligibility,...

On-Boarding/Credentialing Specialist

Origin Management Group/Gateway Advisory Services - Tampa, FL 33613
Prepare credentialing records for review by Origin Management Group's Chief Operating Officer. Serve as a resource specialist for business clients for daily...
Desired Experience: Administrative Experience, Microsoft Powerpoint, NCQA Standards, Microsoft Office
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Medical Record Technician (CDIS) Clinical Document Improveme...

Veterans Affairs, Veterans Health Administration - 4,028 reviews - Tampa, FL
$50,598 - $65,778 a year
Perform reviews of the health record documentation; Medical Record Technician (CDIS) Clinical Document Improvement Specialist / FS70210F....
Desired Experience: Clinical Documentation Certification, Physiology Knowledge, ICD-10, CPT-4, Medical Terminology, Medical Coding, AHIMA
Specialist-Collections Govt
Escalate need for non-Medical Appeals to Specialist, Claims Resolution. Review and process corrections for claims on hold in FI Systems *....
MD Investigative Specialist
For claims involving injuries, has solid understanding of how to review, evaluate, and negotiate injury claims....