Claims Review Specialist jobs in Tarpon Springs, FL

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Contract Review Audit Specialist

Tampa, FL 33634
Conducts daily quality reviews of operations department processes (i.e. Eligibility, enrollment, claims processing and pricing, configuration contract loads,...

Claims Coding Specialist

Tampa, FL 33634
Preferred 1 year of experience in claims coding. Identifies and escalates root cause issues to supervisor for escalated review....

Supv, Claims Audit

Tampa, FL 33634
Claims audit specialists. Reviews Peer Review scores with Auditors and recommends process improvement. Assists in developing of long-range goals for claims...

Configuration Specialist, Sr

Tampa, FL 33634
Knowledge of Claims Processing. Resolves critical errors forwarded from the claims department. Reviews hospital or provider contracts to ensure they can be...

Operations Support Specialist

Tampa, FL 33634
Intermediate Other Understanding of interdependencies on other business units such as Health Services, Provider Relations, Sales, Vendors, Claims....

Coding Research Analyst

Tampa, FL 33634
Evaluates claims coding rule change request from clinical, financial, and claims operations perspectives. Seeks professional feedback from Health Services,...

Coding Research Analyst, Associate

Tampa, FL 33634
Supervisor, Claims Coding Rules. Develops relationship with claims coding rule software vendors. Participate in cross-functional teams to address key claims...

Network Management Rep - Tampa, Florida

Tampa, FL 33634
Provides oversight on claims issues. Reviews and amends provider’s contracts when necessary. Provides continual training to assigned providers on

Quality Practice Advisor-Tampa or Ocala

Tampa, FL 33607
Required Certified Coding Specialist (CCS). Required 2 years of experience in directly related HEDIS medical record review and/or Quality Improvement with...

Clinical Services Specialist

Tampa, FL 33634
Claims / Member Services / Health Services / Call Center / Sales / Provider Relations Training and development / Corporate University/ HMO, managed healthcare...
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