Claims Processor 1

4 days ago


Jacksonville, Florida, United States First Coast Service Options, Inc. Full time
Job Summary

We are seeking a highly skilled Claims Processor 1 to join our team at First Coast Service Options, Inc. as a Healthcare Claims Specialist. In this role, you will be responsible for keying paper claims, evaluating and correcting online edits, and accessing and applying online instructions for the proper resolution of claims suspensions.

Key Responsibilities
  • Prepares first-level (redetermination) case file requests as requested by the Qualified Independent Contractor (QIC) and forwards these case files within the required timeframes established by CMS.
  • Resolves basic, online edits and performs data entry of hard copy claims.
  • Resolves edits on claims suspending on batch edits.
  • Resolves fundamental and basic edits, including making basic mathematical calculations and researching the Inter or Intranets.
Requirements
  • High School diploma or GED.
  • 6 months' work experience, including data entry experience and working on a PC in a Windows or similar environment.
  • Demonstrated mathematical aptitude and ability to add, subtract, multiply, and divide.
  • Demonstrated effective interpersonal and verbal communications skills.
Preferred Qualifications
  • 1-3 years working with medical terminology, procedure, and denial codes.
  • 1 year of experience in claims processing.
  • 1 year of experience in Medicare Fee For Service.
  • 1-3 years of experience as a data processor.
  • 1-3 years meeting production and quality standards.

  • Claims Processor 1

    12 hours ago


    Jacksonville, Florida, United States First Coast Service Options, Inc. Full time

    Job SummaryWe are seeking a skilled Claims Processor to join our team at First Coast Service Options, Inc. As a Claims Processor, you will play a critical role in ensuring the accuracy and efficiency of our claims processing operations.Key ResponsibilitiesPrepare and process claims in a timely and accurate mannerResolve basic on-line edits and perform data...

  • Claims Specialist

    1 week ago


    Jacksonville, Florida, United States Kelly Services Full time

    Job SummaryWe are seeking a skilled Claims Specialist to join our team at Kelly Services. As a Claims Specialist, you will be responsible for processing complex claims, resolving pending claims, and utilizing multiple applications simultaneously.Key ResponsibilitiesProcess complex claims requiring investigation and codingResolve pending claims in a timely...


  • Jacksonville, Florida, United States CCMS & Associates Full time

    Job Opportunity at CCMS & AssociatesJob Summary:CCMS & Associates is seeking a skilled Field Claims Adjuster to join our team in Florida. As a Field Claims Adjuster, you will be responsible for investigating claims, inspecting damages, and recommending claim reserves.Key Responsibilities:Conduct thorough investigations of claims, including obtaining recorded...

  • Investigator I

    2 weeks ago


    Jacksonville, Florida, United States Citizens Property Insurance Full time

    About the RoleCitizens Property Insurance is seeking a highly motivated and detail-oriented Investigator I to join our team. As an Investigator I, you will play a critical role in conducting property claims investigations and identifying potential insurance fraud.Key ResponsibilitiesConduct thorough investigations of property claims to identify potential...


  • Jacksonville, Florida, United States Paul Davis Restoration, Inc. Full time

    Job OverviewAre you looking to make a significant contribution to your community within a diverse and inclusive organization? At Paul Davis Restoration, Inc., we offer a dynamic and expanding environment that supports your personal and professional growth.Position Summary:Paul Davis Restoration, Inc. is a national franchise organization specializing in...


  • Jacksonville, Florida, United States 1-800-Flowers Full time

    Company OverviewAbout 1-800-FLOWERS.COM, Inc.1-800-FLOWERS.COM, Inc. is a premier provider of gift solutions designed to facilitate connections and celebrations. Our e-commerce platform encompasses a diverse portfolio of brands, including 1-800-, Cheryl's Cookies, Harry David, Shari's Berries, and more. We are committed to enhancing customer relationships...


  • Jacksonville, Florida, United States Dream Finders Homes Full time

    Position Overview:We are seeking a dedicated Mortgage Loan Originator to join our dynamic team at Dream Finders Homes. This role is tailored for individuals who thrive in a remote, high-volume mortgage environment, emphasizing stability and continuous training within a client-centric culture.The successful candidate will play a crucial role in assisting our...


  • Jacksonville, Florida, United States Fortegra Full time

    Job SummaryWe are seeking a highly skilled and customer-focused Customer Service Representative to join our team at Fortegra Corporation. As a key member of our customer service team, you will be responsible for delivering exceptional customer support through fast and accurate communication, making necessary changes for plans, coordinating with other team...


  • Jacksonville, Florida, United States Aligned Talent Acquisition Full time

    Job OverviewAligned Talent Acquisition is seeking a highly skilled Labor & Employment Litigation Associate to join our team. This is an excellent opportunity for a talented attorney to work on high-profile cases involving labor law violations, discrimination claims, wrongful termination, and wage and hour disputes.Key ResponsibilitiesConduct thorough legal...

  • MRI Technologist

    1 week ago


    Jacksonville, Florida, United States Ascension Full time

    About the RoleWe are seeking a highly skilled and dedicated MRI Technologist to join our team at Ascension. As a key member of our diagnostic imaging department, you will play a critical role in providing high-quality patient care and contributing to the success of our organization.Key ResponsibilitiesOperate MRI scanners to obtain high-quality images for...


  • Jacksonville, Florida, United States Dream Finders Homes Full time

    {"title": "Mortgage Loan Originator Team Member", "content": "Job SummaryWe are seeking a highly skilled Mortgage Loan Originator Team Member to join our remote team. As a key member of our loan origination staff, you will play a critical role in supporting our clients in qualifying for mortgage loans.The ideal candidate will have a strong background in loan...


  • Jacksonville, Florida, United States Citizens Property Insurance Full time

    About the RoleCitizens Property Insurance is seeking a highly motivated and detail-oriented Investigator I to join our team. As an Investigator I, you will play a critical role in conducting property claims investigations and identifying potential insurance fraud.Key ResponsibilitiesConduct thorough investigations of property claims to identify potential...


  • Jacksonville, Florida, United States Ryan Specialty Full time

    Job SummaryWe are seeking a highly skilled and customer-focused Customer Service Representative to join our team at Ryan Specialty. As a key member of our client support team, you will be responsible for providing exceptional service to our clients, ensuring their needs are met, and resolving any issues that may arise.Key ResponsibilitiesProvide Prompt and...


  • Jacksonville, Florida, United States Dream Finders Homes Full time

    Mortgage Loan Specialist:Dream Finders HomesWe are experiencing significant growth and are in search of a dedicated Mortgage Loan Specialist who can cultivate new business opportunities and referrals while nurturing the strong relationships we have built with our clients and referral partners. The ideal candidate will assist our team in finalizing loan...


  • Jacksonville, Florida, United States Intercare Recruitment Full time

    About the JobWe are seeking a skilled OB/GYN Physician to join our team at Intercare Recruitment. This is a full scope outpatient OBGYN position in a dynamic and supportive environment.Key HighlightsFull scope OBGYN position with a 1:7 APP ratio20 patients per day with 15-minute follow-ups and 30-minute new patient appointments11-12 deliveries per...


  • Jacksonville, Florida, United States LifeNet Health Full time

    About LifeNet HealthLifeNet Health is a leading nonprofit organ procurement organization and tissue processor in the United States, dedicated to saving lives, restoring health, and giving hope.Job SummaryWe are seeking a highly skilled and experienced Enterprise Solutions Manager to lead our development team in designing, developing, and supporting LifeNet...


  • Jacksonville, Florida, United States Life Care Full time

    Position OverviewEmployment Type: Full-timeWork Schedule: Monday - FridayHours: 8:30am - 5:00pmCompensation: $20.00 per hourABOUT US: Join our committed team at Life Care Services, where we prioritize excellence in senior living. Our community is dedicated to enhancing the lives of our residents through exceptional service and support. As part of our...

  • Senior Attorney

    1 week ago


    Jacksonville, Florida, United States Jobot Full time

    About the RoleWe are seeking a highly skilled and experienced Associate Attorney to join our team at Jobot. As an Associate Attorney, you will be responsible for handling a variety of legal matters related to insurance defense, product liability, premises liability, general liability, medical malpractice, auto claims, and more.Key ResponsibilitiesRepresent...


  • Jacksonville, Florida, United States Intercare Recruitment Full time

    OB/GYN Physician Opportunity in Jacksonville Beach, FL **About the Job** We are seeking a Full Scope OB/GYN Physician to join our team in Jacksonville Beach, FL. As a member of our team, you will have the opportunity to work in a dynamic and supportive environment, providing high-quality patient care and contributing to the growth and success of our...


  • Jacksonville, Florida, United States Wood, Smith, Henning & Berman LLP Full time

    Exciting Opportunity at WSHBWSHB, a leading national civil litigation defense firm, is seeking highly skilled associate attorneys with 1-10 years of relevant experience to join its expanding construction defect and general liability practice groups in Orlando and Jacksonville. As a licensed attorney in Florida, you will be part of a dynamic team handling a...