Medical Claims Examiner
2 weeks ago
Analyze and adjudicate a variety of claim types to include facility, professional, inpatient and outpatient services
•Follow claims adjudication rules to assure that all claims are adjudicated in accordance with CMS rules and regulations and our Client's internal criteria
• Review different lines of business to include Medicare, Medicaid and Commercial services adherence to the contracts and timeliness guidelines
• Authorize claim payments within established limits; otherwise forward to Claims Manager
• Potentially process refunds appeals, disputes and adjustments (when applicable);
• Identify process improvement opportunities within the claim department and recommend system enhancements
• Handles any additional responsibility which may be assigned
Education :
• High School Diploma or equivalent required
Experience :
• Minimum of one-year experience working closely with health claims or in a claims processing/adjudication environment; required
. Abundance of opportunities for promotion within for those looking for upward mobility
.Meeting and exceeding metrics is rewarded
Technical Skills / Knowledge:
• Understanding of health claims processing/adjudication
• Ability to perform basic to intermediate mathematical computation routines
• Medical terminology strongly preferred
• Understanding of ICD-9 & ICD-10
• Basic MS office computer skills
• Ability to work independently or within a team
• Time management skills
Will go remote after 6 months of employment.
-
Workers Compensation Claims Examiner
3 weeks ago
Tampa, United States Packard Claims Administration Full timeJob DescriptionJob DescriptionPackard Claims Administration is a fast paced and growing TPA looking for a Workers Compensation Claims Examiner to join our team. We pride ourselves on having a family oriented environment that makes for an enjoyable place to work.Responsibilities:Must have and maintain a FL adjusters license (620 Florida All lines Adjusting...
-
Medical Claims Examiner
3 weeks ago
Tampa, United States SNI Companies Full timeJob Description Analyze and adjudicate a variety of claim types to include facility, professional, inpatient and outpatient services •Follow claims adjudication rules to assure that all claims are adjudicated in accordance with CMS rules and regulations and our Client's internal criteria •Review different lines of business to include Medicare, Medicaid...
-
Medical Claims Examiner
2 weeks ago
Tampa, United States SNI Companies Full timeJob Description Analyze and adjudicate a variety of claim types to include facility, professional, inpatient and outpatient services • Follow claims adjudication rules to assure that all claims are adjudicated in accordance with CMS rules and regulations and our Client's internal criteria • Review different lines of business to include Medicare,...
-
Medical Claims Examiner
4 weeks ago
Tampa, United States SNI Companies Full timeAnalyze and adjudicate a variety of claim types to include facility, professional, inpatient and outpatient services·Follow claims adjudication rules to assure that all claims are adjudicated in accordance with CMS rules and regulations and our Client's internal criteria· Review different lines of business to include Medicare, Medicaid and Commercial...
-
Medical Claims Examiner
4 weeks ago
Tampa, United States SNI Companies Full timeAnalyze and adjudicate a variety of claim types to include facility, professional, inpatient and outpatient services·Follow claims adjudication rules to assure that all claims are adjudicated in accordance with CMS rules and regulations and our Client's internal criteria· Review different lines of business to include Medicare, Medicaid and Commercial...
-
Medical Claims Examiner
4 weeks ago
Tampa, United States SNI Companies Full timeAnalyze and adjudicate a variety of claim types to include facility, professional, inpatient and outpatient services·Follow claims adjudication rules to assure that all claims are adjudicated in accordance with CMS rules and regulations and our Client's internal criteria· Review different lines of business to include Medicare, Medicaid and Commercial...
-
Medical Claims Examiner
3 weeks ago
Tampa, United States SNI Companies Full timeAnalyze and adjudicate a variety of claim types to include facility, professional, inpatient and outpatient services Follow claims adjudication rules to assure that all claims are adjudicated in accordance with CMS rules and regulations and our Client's internal criteria Review different lines of business to include Medicare, Medicaid and Commercial...
-
Tampa, United States Imagenet LLC Full timeJob DescriptionJob DescriptionImagenet is a premier healthcare technology company that has taken medical claims processing and document management to new levels of service, security and efficiency. We are looking for Claims Examiners to join our rapidly growing team in Tampa. Experience is preferred but not necessary. Candidates with the right aptitude and...
-
Senior Litigation Claims Examiner
1 week ago
Tampa, United States Heritage Insurance Full timePosition Summary: Investigates, evaluates, reserves, negotiates and settles assigned claims in accordance with Best Practices. Provides quality claim handling and superior customer service on assigned claims, while engaging in indemnity and expense management. Promptly manages claims by completing essential functions including contacts, investigations,...
-
Medical Only Adjuster
3 weeks ago
Tampa, United States CorVel Full time** Medical Only Adjuster (Claim Specialist)** **Job Category****:** Enterprise Comp (Claims) **Requisition Number****:** MEDIC04030 Showing 1 location **Job Details** **Description** CorVel is seeking a full time Medical Only Claims Specialist. The Medical Only Claims Specialist manages non-complex and non-problematic, medical only claims and minor lost-time...
-
Workers' Compensation Claims Specialist
3 weeks ago
Tampa, United States Fourth Enterprises, LLC Full timeThe Workers' Compensation Claims Specialist is responsible for managing and processing claims related to workplace injuries or illnesses for a nationwide Professional Employer Organization (PEO). The Claims Specialist works with employers, employees, medical providers, and insurance carriers' Adjusters to ensure that the claims are handled in a timely &...
-
Claims Trainee
1 week ago
Tampa, United States AssuranceAmerica Full timeJob Description Our Company: At AssuranceAmerica, we are more than a unique blend of insurance assets. We believe in creating a culture where every associate can learn and grow. We strive to create a work environment to meet associate needs and we are determined to achieve excellence in everything we do. This is an opportunity to join a dynamic team in a...
-
Medical Biller Coder
2 weeks ago
Tampa, United States Ocana Medical Center LLC Full timeJob DescriptionJob Description Job Description:We seek an accurate, detailed-oriented Medical Biller/Coder to join our team. You will be key in reviewing medical records and collecting, monitoring, documenting, and submitting claims and encounters. You will also gather and analyze HEDIS performance data.Candidates must be bilingual (English & Spanish), with...
-
Medical Collections Specialist
2 weeks ago
Tampa, United States Blackstone Medical Services Full timeJob DescriptionJob DescriptionBlackstone Medical Service is the #1 home sleep apnea testing company in the entire country as well as one of the fastest growing companies in the Tampa Bay area! Our owner and CEO, Vick Tipnes started this company 10 years ago out of his kitchen. Vick is a motivational speaker, entrepreneur and social media influencer with over...
-
Claims Manager
3 weeks ago
Tampa, United States Truist Full timeESSENTIAL DUTIES AND RESPONSIBILITIES Following is a summary of the essential functions for this job. Other duties may be performed, both major and minor, which are not mentioned below. Specific activities may change from time to time. 1. Coach experienced Claim Team to identify client needs and develop strategies for dealing with claim and service...
-
Medical Billing Associate
3 weeks ago
Tampa, United States Momentum Medical Management Llc Full timeJob DescriptionJob DescriptionMomentum Medical is seeking a Personal Injury Medical Biller to join a growing medical team! Must be able to work independently in a high volume, fast pace atmosphere. Minimum of 2 years in collections and medical billing experience preferred.Duties will include but are not limited too: Posting payments, Processing CMS1500...
-
Medical Billing Associate
3 weeks ago
Tampa, United States Momentum Medical Management Llc Full timeJob DescriptionJob DescriptionMomentum Medical is seeking a Personal Injury Medical Biller to join a growing medical team! Must be able to work independently in a high volume, fast pace atmosphere. Minimum of 2 years in collections and medical billing experience preferred.Duties will include but are not limited too: Posting payments, Processing CMS1500...
-
Medical Assistant
3 weeks ago
Tampa, United States Ocana Medical Center LLC Full timeJob DescriptionJob DescriptionPOSITION SUMMARYAs a Medical Assistant (MA) at Ocana Medical Center, this position performs various duties and responsibilities in a manner that emphasizes quality of care and customer service. Patient services are the key priority in this position, to foster an environment that promotes patient comfort and trust. The position...
-
Medical Assistant
1 month ago
Tampa, United States Florida Medical Clinic Full timeJob DescriptionJob DescriptionOur Vision is to be the best choice for healthcare in our communityJob Title: Medical AssistantDepartment: Internal Medicine Lake ParkReports to: Office ManagerJob Summary: Assists providers and manages clinical functions in the department, Medical Terminology, Hard Working, multitasking, patient oriented. Medical Assistant with...
-
Medical Billing Collections Specialist
2 weeks ago
Tampa, United States Stymco Medical Full timeJob DescriptionJob DescriptionAt Stymco Medical LLC our mission is to provide the most modern and effective durable medical devices, such as, braces, mobility items, wound care, ostomy, enteral supplies between others to patients through our provider network and to provide the highest quality and professional service to providers and patients alike. To...