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Paradigm

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Customer Service Associate
Seen active today Posted Aug 19
Tampa, FL, United States Entry

Role highlights

  • This role requires strong problem-solving skills to investigate complex issues across multiple systems and collaborate with internal depart…
  • Proficient with Microsoft Office (Outlook, Teams, Excel, Word), CRM/contact center systems, and telephony tools.

Elevance Health

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Utilization Management Representative I
Seen active today Posted Aug 18
Tampa, FL, United States Mid

Role highlights

  • The Utilization Management Representative I is responsible for coordinating cases for precertification and prior authorization review.
  • Determines contract and benefit eligibility; provides authorization for inpatient admission, outpatient precertification, prior authorizati…

Rx relief

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Pharmacy Insurance Verification Specialist
Seen active today Posted Aug 18
Tampa, FL, United States Entry Temporary $19-20/hr

Role highlights

  • Solid understanding of Workers' Compensation claim lifecycles, pharmacy revenue cycles, and insurance verification workflows.
  • Quality Assurance: Review patient files and prescription data for accuracy and completeness prior to releasing claims for billing.

The Elevance Health Companies, Inc.

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Utilization Management Rep I (US)
Seen active yesterday Posted Aug 18
Tampa, FL, United States Mid Full Time

Role highlights

  • The Utilization Management Representative I is responsible for coordinating cases for precertification and prior authorization review.
  • Determines contract and benefit eligibility; provides authorization for inpatient admission, outpatient precertification, prior authorizati…

PruittHealth

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Senior Nurse Consultant- ALF
Seen active today Posted Aug 18
Clearwater, FL, United States Senior Full Time

Role highlights

  • Stay connected with CMS regulations, interpretive guidance, and best practices in long term care compliance KNOWLEDGE, SKILLS, ABILITIES: C…
  • Prior experience conducting mock surveys or participation in state/federal survey processes (preferred) Familiarity with Plans of Correctio…

Elevance Health

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Financial Operations Recovery Specialist I
Seen active today Posted Aug 17
Tampa, FL, United States Mid

Role highlights

  • The Financial Operations Recovery Specialist I is responsible for setting up and adjusting claims overpayments that have been previously id…
  • May perform collection activities to ensure the recovery of overpayments and maintenance of unprocessed cash and accounts receivable balanc…

BOCC Career Site

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Healthcare Svcs Review Nurse
Seen active yesterday Posted Aug 13
Tampa, FL, United States Mid

Role highlights

  • Knowledge of Utilization Review and Case Management policies and procedures.
  • Participate and assist with the performance improvement programs of networks, providers and hospitals.

UnitedHealth Group

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Coding Operations Support Analyst
Seen active 2 days ago Posted Aug 13
Tampa, FL, United States Senior

Role highlights

  • Required Qualifications: High School Diploma / GED Active coding credentials through AHIMA OR AAPC (CCS, CIC, CPC, COC, CPC-P, RHIT,…
  • Whether you are looking for a role in a clinical setting or supporting those who provide care, we have opportunities…

Paradigm

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LPN Clinical Coordinator
Seen active today Posted Aug 14
Tampa, FL, United States Mid

Role highlights

  • The LPN Clinical Coordinator plays a critical role in coordinating and managing medical and healthcare-related services for injured workers…
  • Education/Training: Current LPN state licensure in good standing with the State Board of Nursing.

AMERILIFE US, LLC

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Medicare Retention Agent
Seen active yesterday Posted Aug 14
Tampa, FL, United States Mid Full Time

Role highlights

  • Job Description Key Responsibilities Make consistent outbound calls to current Medicare clients to support policy effectuation and ensure s…
  • Stay current on Medicare regulations, plan changes, and compliance requirements (CMS guidelines).

Elevance Health

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Financial Operations Recovery Specialist I
Seen active today Posted Aug 17
Tampa, FL, United States Mid

Role highlights

  • The Financial Operations Recovery Specialist I is responsible for setting up and adjusting claims overpayments that have been previously id…
  • May perform collection activities to ensure the recovery of overpayments and maintenance of unprocessed cash and accounts receivable balanc…

PrideStaff

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Medical Biller
Seen active today Posted Aug 13
Clearwater, FL, United States Entry Temporary $22.50-24/hr

Role highlights

  • WHAT YOU WILL DO Manage and oversee the daily billing operations and workflows for a busy healthcare office environment Coordinate…
  • PrideStaff, a nationally recognized staffing firm, is currently seeking a Healthcare Billing Coordinator on behalf of a highly respected, e…

More roles at PrideStaff

The Oncology Institute of Hope and Innovation

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UM Authorization Analyst 2 Bilingual
Seen active yesterday Posted Aug 10
Tampa, FL, United States Mid $71k-85k/yr

Role highlights

  • This role includes reviewing authorization requests, maintaining compliance with regulations, and coordinating with healthcare providers an…
  • Demonstrating expertise in health plan delegation requirements, including Preparation and submission of reports, participate in implementat…

UHS

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HIM/MEDICAL RECORDS SPECIALIST
Seen active today Posted Aug 10
Clearwater, FL, United States Mid Full Time

Role highlights

  • Must be able to complete the following requirements of the position as outlined, chart assemble and analyzation, process medical records…
  • Other duties as assigned by the HIM Director.

Qualifacts Systems, LLC.

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RCMS Configuration Specialist I
Seen active yesterday Posted Aug 10
Tampa, FL, United States Mid Full Time

Role highlights

  • Knowledge, Skills, and Abilities of the RCMS Configuration Specialist I Comprehensive understanding of revenue cycle management systems, bi…
  • Qualifications of the RCMS Configuration Specialist I Bachelor’s degree or equivalent experience using EHR applications for medical billing…

More roles at Qualifacts Systems, LLC.

Quest Diagnostics

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Data Entry Clerk - Billing I
Seen active today Posted Aug 6
Tampa, FL, United States Entry Full Time $17.20/hr

Role highlights

  • 1+ years of Billing Knowledge, Billing Data Entry, Strong Customer Service Skills, and Insurance Payor Knowledge Demonstrated ability in us…
  • Demonstrates competency in eligibility, billing and receivable systems and associated applications.

Johns Hopkins Medicine

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Revenue Integrity Specialist II
Seen active today Posted Aug 5
St. Petersburg, FL, United States Mid Full Time

Role highlights

  • Bachelor’s degree preferred, preferably in business or healthcare Coding certification (CPC, CCS, CCS-P, COC), or certification in auditing…
  • Career growth and development Diverse and collaborative working environment Affordable and comprehensive benefits package including Tuition…

More roles at Johns Hopkins Medicine

TEKsystems

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Insurance Verification Specialist - Remote
Seen active today Posted Aug 3
Tampa, FL, United States Mid Contract $23.80/hr

Role highlights

  • In this role, you will provide exceptional customer service while assisting patients and healthcare providers through patient assistance pr…
  • The ideal candidate will bring strong insurance verification experience, a customer-focused mindset, and the ability to navigate complex pa…

Medix Staffing Solutions

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Hospital Biller
Seen active today Posted Jul 31
Tampa, FL, United States Mid Contract $22-25/hr

Role highlights

  • Key Responsibilities Work the daily hospital billing claim-edit alpha split within Epic.
  • Qualifications Three to five years of hospital billing experience preferred.

More roles at Medix Staffing Solutions

Integrity Marketing Group

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Health Insurance Claims Adjuster
Seen active 3 days ago Posted Jul 24
Clearwater, FL, United States Mid Full Time

Role highlights

  • Job Summary: Analyze medical claims to determine the extent of insurance carrier liability.
  • Primary Responsibilities other duties may be assigned as necessary: Examine/perform/research & make decisions necessary to properly adjudic…

More roles at Integrity Marketing Group

Molina Healthcare

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Care Review Clinician (RN)
Seen active today Posted Jul 24
Tampa, FL, United States Entry Full Time $26.41-51.49/hr

Role highlights

  • Responsible for verifying that services are medically necessary and align with established clinical guidelines, insurance policies, and reg…
  • Required Qualifications At least 2 years experience, including experience in hospital acute care, inpatient review, prior authorization, ma…

Hospital RCM Services

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Payment & Research Representative
Seen active today Posted Jul 22
Tampa, FL, United States Mid

Role highlights

  • Performs manual and electronic posting functions for all Managed Care, Commercial and Government payors for all patient accounts, including…
  • Post payment corrections, payment transfers, NSF’s, inter-facility transfers, Payroll deductions and any other cash transactions for A/R ac…

Humana

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IPA Consultative Coder - North Florida (Tampa/Brandon)
Seen active today Posted Jun 30
Brandon, FL, United States Mid Full Time $59.3k-80.9k/yr

Role highlights

  • Use your skills to make an impact Required Qualifications: 3+ years of risk adjustment Medical Coding or risk adjustment Provider…
  • IPA Coding Helpdesk Support Participate in a daily coder helpdesk (virtual/Zoom-based), providing real-time support to providers within ass…

Wipro

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Service Delivery Head, Claims BPaaS DeliveryService Delivery Head...
Seen active today Posted Jun 25
Tampa, FL, United States Senior

Role highlights

  • This role requires deep expertise in health insurance payor claims (not provider claims), technology, the broader claims ecosystem—includin…
  • Essential Duties and Responsibilities Operational Leadership & Delivery Oversee day-to-day health insurance payor claims operations, ensuri…

AMERILIFE US, LLC

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Compliance Analyst, Ad Approval
Seen active yesterday Posted Mar 9
Clearwater, FL, United States Mid Full Time

Role highlights

  • Job Summary This position will be part of a team of associates that is primarily responsible for reviewing marketing collateral…
  • Respond to information requests from insurance carriers, specifically regarding compliance with CMS requirements for health affiliate and p…
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