Claims Review Specialist jobs in Tarpon Springs, FL

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HEDIS Abstractor
2+ years of experience in directly related HEDIS medical record review and/or Quality Improvement with experience in data and chart reviews to provide...
Desired Experience: RN, Social Work Certification, Certified Nurse Practitioner, NCQA Standards, CPT Coding, Counseling Certification, CPHQ, Marriage and Family Therapy Certification, Medical Coding Certification, Managed Care
Collector - Billing + Collections
Tampa, FL 33614
Patient Account Specialist. Review EOPs/EOMBs/EOBs for accuracy of patient responsibility. Reviews payer payment explanation for accuracy of patient...
Desired Experience: Time Management, Accounts Receivable, Excel, CPT Coding, Microsoft Office, Microsoft Access
Registered Nurse- Part-time position
Pediatric Epilepsy & Neurology Specialists (PENS) has been serving the Tampa Bay area since 2001. Review Prior Authorization Criteria for medications for Prior...
Desired Experience: Bilingual, BC/BE, RN, Pediatrics Experience
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Claims Audit Specialist

Tampa, FL 33634
Conducts daily quality reviews of operations department processes (i.e. Eligibility, enrollment, claims processing and pricing, configuration contract loads,...
Desired Experience: Time Management, Microsoft Powerpoint, Excel, CPT Coding, Microsoft Office, Microsoft Word, Medical Terminology, Managed Care

Claims & Denials Specialist

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, CPT Coding, Medical Terminology
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Claims Operations Support Specialist

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

Claims - Casualty Specialist II

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

Technical Claims Specialist

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 Coding, 10 Key Calculator
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CLAIMS RESOLUTION SPECIALIST

Tampa, FL
Responsible for prompt and accurate follow-up of all unpaid claims. File both primary and secondary claims to the insurance carriers, with appropriate records...
Desired Experience: Microsoft Office

Claims Coding Specialist

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 Coding

Claims Audit Specialist - Senior

Tampa, FL 33634
Supv, Claims Audit. Conducts daily quality reviews of operations department processes (i.e. Eligibility, enrollment, claims processing and pricing,...
Desired Experience: Time Management, Microsoft Powerpoint, Excel, CPT Coding, Microsoft Office, ICD-9, Microsoft Word, Medical Terminology

Document & Training Specialist

Tampa, FL 33634
Preferably in Claims or Configuration. Leads training programs for Claims and Configuration. Ability to perform detailed review, research, and analysis to...
Desired Experience: Microsoft Word, Microsoft Powerpoint, Excel

Sr Academic Program Specialist

Tampa, FL
$42,500 a year
4373 / Sr Academic Program Specialist. Reviews and requests updates for effective web pages concerning scheduling and room reservations, commencement, and other...
Desired Experience: Administrative Experience, Ellucian
Lead Collector- Billing + Collections
Tampa, FL 33614
Lead Patient Account Specialist. Reviews and processes Patient Waiver Applications. Guides internal and external customers encompassing all aspects of insurance...
Desired Experience: Project Management, Accounts Receivable, Excel, CPT Coding, Microsoft Office, Microsoft Access
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