Top 120 Claims representative Jobs in Miami, Fl

Insurance Verification Representative - Remote (Tri-County Area)
University of Miami —Medley, FL
- Full-time
- Remote
- Bilingual
- Computer literacy
- Mid-level
- Health insurance
- Dental insurance
Remote Customer Service/Sales Representative
Agent Alliance —Hollywood, FL
- $65,000 - $70,000 a year
- Full-time
- Remote
- Entry level
- Paid training
- Health insurance
Quick Apply
7d
Insurance Verification Representative - UHealth SoLé Mia
University of Miami —North Miami, FL
- Full-time
- Bilingual
- Computer literacy
- High school diploma or GED
- Health insurance
- Dental insurance
Claims Examiner
Stellar Human Resource Services LLC —Miami, FL
- Full-time
- Entry level
Quick Apply
Customer Service Representative - State Farm Agent Team Member
Jesse Mesa - State Farm Agent —Miami, FL
- $50,000 - $70,000 a year
- Full-time
- Office
- Leadership
- Communication skills
- Paid training
- Paid holidays
Quick Apply
REMOTE Legal Customer Service Representative - Retainer Specialist
Advocacy Solutions —Fort Lauderdale, FL
- $18 an hour
- Full-time
- Remote
- Bilingual
- Sales
- Computer literacy
- Paid holidays
- Disability insurance
Quick Apply
Specialist, Appeals & Grievances
Molina Healthcare —Doral, FL
- $16.40 - $31.97 an hour
- Full-time
- Medical office experience
- Research
- Mid-level
- Health insurance
Patient Accounts Representative I - FT
Larkin Community Hospital —South Miami, FL
- Full-time
- Spanish
- Computer literacy
- HIPAA
Quick Apply
Grievance and Appeals Analyst I
Solis Health Plans —Doral, FL
- $22 - $24 an hour
- Weekends as needed
- Ability to walk for extended periods
- Research
- Mid-level
Quick Apply
Contact Center Representative
Systems Integration, Inc. —Miami, FL
- Seasonal
- Remote
- Background check
- Computer literacy
- High school diploma or GED
- Paid training
Quick Apply
Patient Services Representative - Insurance Verification
TOC Sports and Regenerative Medicine —Pembroke Pines, FL
- $18 - $22 an hour
- Full-time
- Medical office experience
- HIPAA
- In-person
- Health insurance
- Dental insurance
Quick Apply
Customer Service Representative - State Farm Agent Team Member
RODRIGO PLANTER - State Farm Agent —North Miami Beach, FL
- $40,000 - $50,000 a year
- Full-time
- Office
- Communication skills
- Entry level
- Paid time off
- Opportunities for advancement
Quick Apply
Claims Adjuster-Worker's Compensation
Broward County Board of County Commissioners —Fort Lauderdale, FL
- $56,594.10 - $90,324.62 a year
- Full-time
- Customer service
- Mid-level
- Bachelor's degree
- Paid training
- Health savings account
Customer Service Representative - State Farm Agent Team Member
Ileana Cabrera-Rodriguez - State Farm Agent —Coral Gables, FL
- $45,000 - $65,000 a year
- Full-time
- Office
- Communication skills
- Entry level
- Health insurance
- 401(k)
Quick Apply
Claims Associate II
Stellar Human Resource Services LLC —Miami, FL
- Full-time
- Mid-level
- Office
Quick Apply
Medicare Retention Specialist
Solis Health Plans —Doral, FL
- $20 - $21 an hour
- Weekends as needed
- Spanish
- Microsoft Excel
- Microsoft Outlook
- Health insurance
Quick Apply
Insurance Sales Representative
Ashley Lane State Farm —Cooper City, FL
- $35,000 - $80,000 a year
- Full-time
- Background check
- Sales
- Computer literacy
- Paid time off
- Opportunities for advancement
Quick Apply
Insurance Commercial Lines Account Executive - Team Leader
SolomonEdwards —Miami, FL
- $175,000 - $200,000 a year
- Email
- Remote
- Bachelor's degree
- Team management
- Travel
- Health insurance
- Dental insurance
Quick Apply
8d
Licensed Insurance Customer Service
State Farm Agency - Davie, FL —Davie, FL
- $30,000 - $55,000 a year
- Full-time
- Office
- In-person
- Communication skills
- Paid time off
- Opportunities for advancement
Quick Apply
1d
Customer Service Representative - State Farm Agent Team Member
Gus Cisneros - State Farm Agent —Miami, FL
- $34,000 - $40,000 a year
- Full-time
- Spanish
- Office
- Communication skills
- Health insurance
- Paid time off
Quick Apply

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Insurance Verification Representative - Remote (Tri-County Area)

University of Miami -
Medley, FL

Apply Now

Job Details

Full-time

Benefits

Health insurance
Dental insurance

Qualifications

Customer communication
Overseeing health insurance pre-certification
High school diploma or GED
Healthcare referral management
Working with individuals from diverse cultural backgrounds
Computer skills
Patient interaction
Patient registration

Full Job Description

Current Employees:

If you are a current Staff, Faculty or Temporary employee at the University of Miami, please click here to log in to Workday to use the internal application process. To learn how to apply for a faculty or staff position, please review this tip sheet .

The University of Miami/UHealth Central Business Office has an exciting opportunity for a full-time Insurance Verification Representative to work remotely.

CORE RESPONSIBILITIES

Accounts are completed in a timely manner in support of patient satisfaction and allow for referral and authorization activities prior to the patient’s date of service
Verification of eligibility and benefits via RTE in UChart, online insurance websites, telephone or other source of automated services
Add and/or edit insurance information in UChart such as validating that the correct guarantor account and plan listed in patient’s account with accurate subscriber information, policy number, and claims address and plan order.
Completes the checklist and document co-pay.
Creates referral if applicable, “Benefit only” or “Preauthorization”, and documents benefits information: deductible, co-insurance and out of pocket benefits
Meets productivity standards for assigned work queue, QA goal of 95% or greater and maintains WQ current at 14 days out with minimum daily pending visits
Assists in educating and acts as a resource to patients, primary care and specialty care practices within the UHealth system and externally
Contact Primary Care Physician offices and/or Health Plans to obtain authorization or referral for scheduled services according to authorization guidelines listed in UHealth Contract Summary. Submits all necessary documentation required to process authorization request 2
Obtains authorization for both facility and provider for POS 22 and POS 19 clinics and provider only for POS 11 clinic locations\
Enters and attaches authorization information in referral section of UChart
Approves referral and financially clear visits
Communicates with patients and/or departments regarding authorization denial and/or re-direction of patients by health plan or PCP office
Contact the Departments and/or patient when additional information is required of them or to alert regarding pending authorization status
Participates in process improvement initiatives 15% Customer Service
Provides customer service and assists patients and other UHealth staff with insurance related questions according to departmental standards
Ensures that patients are aware of issues regarding their financial clearance and educated on the referral/authorization process
Collaborates with Department and Patient Access teams to ensure that timely and concise communication occurs.
Ensures service recoveries and escalations are implemented with the guidance of their supervisors and according to departmental standards and guidelines
Performs other duties as assigned

This list of duties and responsibilities is not intended to be all-inclusive and may be expanded to include other duties or responsibilities as necessary.

CORE QUALIFICATIONS

Insurance Verification Representative

High School Diploma or equivalent
Minimum 1 year of relevant work experience
Computer literate (EPIC scheduling and registration application experience a plus).
Strong written and oral communication skills.
Able to work in a team environment.
Graceful under pressure and stressful situations

Sr. Insurance Verification Representative

High School Diploma or equivalent
(3) years of direct experience in Insurance Verification and Registration.
Computer literate (EPIC scheduling and registration application experience a plus).

Minimum Qualifications (Essential Requirements)

Strong written and oral communication skills.  Able to work in a team environment.
Graceful under pressure and sensitive situations
High School Diploma or equivalent and (3) years’ direct experience Insurance Verification and Registration. 
Computer literate (EPIC scheduling and registration application experience a plus).
Strong written and oral communication skills.  Able to work in a team environment.
Graceful under pressure and sensitive situations
Demonstrated knowledge of insurances, including authorization/referrals guidelines and requirements
Demonstrated ability to communicate effectively in written and verbal form. Bi-lingual knowledge a plus
Demonstrated ability to communicate effectively with physicians, customers, teammates and other staff
Ability to interact and assist patients of all ages, cultural background and with special needs, with a passion for providing excellent service and care
Ability to work under a high level of stress with time constraints while maintaining composure and sensitivity to each patient’s specific needs
Maintain a high level of diplomacy when dealing with stressful situations · Is innovative, proactive and resourceful in problem solving

Any appropriate combination of relevant education, experience and/or certifications may be considered.

#LI-NN1

The University of Miami offers competitive salaries and a comprehensive benefits package including medical, dental, tuition remission and more.

UHealth-University of Miami Health System, South Florida's only university-based health system, provides leading-edge patient care powered by the ground breaking research and medical education at the Miller School of Medicine. As an academic medical center, we are proud to serve South Florida, Latin America and the Caribbean. Our physicians represent more than 100 specialties and sub-specialties, and have more than one million patient encounters each year. Our tradition of excellence has earned worldwide recognition for outstanding teaching, research and patient care. We're the challenge you've been looking for.

The University of Miami is an Equal Opportunity Employer. Applicants and employees are protected from discrimination based on certain categories protected by Federal law.

Job Status:

Full time

Employee Type:

Staff

Apply Now

Refine Your Search

claims representative jobs in miami, fl

Insurance Verification Representative - Remote (Tri-County Area)

Remote Customer Service/Sales Representative

Insurance Verification Representative - UHealth SoLé Mia

Claims Examiner

Customer Service Representative - State Farm Agent Team Member

REMOTE Legal Customer Service Representative - Retainer Specialist

Specialist, Appeals & Grievances

Patient Accounts Representative I - FT

Grievance and Appeals Analyst I

Contact Center Representative

Patient Services Representative - Insurance Verification

Customer Service Representative - State Farm Agent Team Member

Claims Adjuster-Worker's Compensation

Customer Service Representative - State Farm Agent Team Member

Claims Associate II

Medicare Retention Specialist

Insurance Sales Representative

Insurance Commercial Lines Account Executive - Team Leader

Licensed Insurance Customer Service

Customer Service Representative - State Farm Agent Team Member

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