Claims Review Specialist jobs in Tarpon Springs, FL

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Claims Audit Specialist

Tampa, FL 33634
Supv, Claims Audit. Conducts daily quality reviews of operations department processes (i.e. Eligibility, enrollment, claims processing and pricing,...
Time ManagementMicrosoft PowerpointExcelCPT CodingMicrosoft Officeand 4 more...

Claims Coding Specialist

Tampa, FL 33634
Supv, Claims Coding Rules. Preferred 1 year of experience in claims coding. Identifies and escalates root cause issues to supervisor for escalated review....
SharePointEMR SystemsMedical TerminologyCPT CodingICD-9

Operations Support Specialist

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

Appeals Intake Specialist

Tampa, FL 33603 (South Seminol Heights area)
Ensures timely processing and review of documentation to meet departmental goals and state specific benchmarks for timeliness....
Data EntryMicrosoft WordExcel

Claims Audit - Supervisor

Tampa, FL 33634
Claims audit specialists. Reviews Peer Review scores with Auditors and recommends process improvement. Dir, Claims Audit. Reviews all second level rebuttals....
Time ManagementMicrosoft PowerpointCPT CodingExcelICD-9and 3 more...

Medical Coding Specialist

Tampa, FL 33634
Required Certified Coding Specialist (CCS). Support claims, configuration, PRT, and/or appeal & grievances teams as necessary....
ICD-10CPT CodingExcelICD-9Microsoft Wordand 2 more...

Network Management Representative

Tampa, FL 33607 (Carver City area)
Provides oversight on claims issues. Reviews and amends provider’s contracts when necessary. Provides continual training to assigned providers on wellcare.com...

Senior Specialist - Learning & Development

Tampa, FL 33634
Reviews all programs assigned and continuously ensures they meet the rigorous standards that are set forth. Government Programs, Medicare and Medicaid/Clinical...
Microsoft PowerpointSocial Work LicenseRNMicrosoft OfficeExceland 1 more...

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...
Time ManagementEMR SystemsRHITMicrosoft PowerpointCPT Codingand 8 more...

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