Top 157 Insurance manager Jobs in South Miami, Fl

Healthcare Claims and Fee for Service Supervisor
Provider Network Solutions LLC —Miami, FL
- $63,000 - $65,000 a year
- Full-time
- 5 years
- HIPAA
- Bachelor's degree
Quick Apply
12d
Commercial Lines Account Manager
WAHVE —Miami, FL
- Part-time
- Remote
- Senior level
- Marketing
- Commercial
- Health insurance
- 401(k)
Life Insurance Sales Manager
CATHOLIC LIFE INSURANCE —Miami, FL
- $50,000 - $250,000 a year
- Part-time
- Remote
- Background check
- Sales
- Mid-level
- Flexible schedule
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
220 Licensed Insurance Sales Store Manager (SIGN ON BONUS)
Freeway Insurance Services America, LLC —Palmetto Bay, FL
- $18 - $21 an hour
- Urgently hiring
- Spanish
- Management
- English
- Paid holidays
- Health insurance
Quick Apply
8d
Fast Track Financial Sales Manager/Partner ***Local Candidates Only***
New York Life Insurance Company —Miami, FL
- $60,000 - $150,000 a year
- Full-time
- Hybrid work
- Mid-level
- Business development
- US work authorization
- AD&D insurance
- Disability insurance
Quick Apply
Automotive Finance Manager
Spitzer Autoworld —Homestead, FL
- Full-time
- Background check
- Clean driving record
- Dealership
- Paid training
- Health savings account
Quick Apply
8d
Regional Sales Manager (South Florida)
Atradius —Miami, FL
- Up to $90,000 a year
- Full-time
- Mid-level
- Finance
- Business development
- Paid holidays
- Health insurance
Personal Lines Account Manager
Impact Performance Team —Miami, FL
- $65,000 - $85,000 a year
- Full-time
- Hybrid work
- Mid-level
- Office
- 2 years
- Disability insurance
- Health insurance
Quick Apply
Account Manager
BEST DOCTORS INSURANCE SERVICES LLC —Miami, FL
- Full-time
- Microsoft Excel
- Microsoft Outlook
- Mid-level
Quick Apply
Finance and Insurance (F&I) Manager
The Collection —Coral Gables, FL
- Weekends as needed
- Clean driving record
- Dealership
- Ability to walk for extended periods
- Paid holidays
- Health insurance
Quick Apply
Sales Manager
Colonial Life —Miami Beach, FL
- Mid-level
- Mentoring
Legal Office Manager
Kemper Insurance —Doral, FL
- Full-time
- Hybrid work
- Microsoft Word
- Microsoft Excel
- Research
Quick Apply
10d
Account Manager - State Farm Agent Team Member
Lexi Goza - State Farm Agent —Miami, FL
- $70,000 - $90,000 a year
- Full-time
- No experience needed
- Office
- Leadership
- Health insurance
- Dental insurance
Quick Apply
Client Service Manager
Gallagher —Miami, FL
- Full-time
- Mid-level
- 3 years
- High school diploma or GED
Account Manager - State Farm Agent Team Member
Madison Riordan - State Farm Agent —Pembroke Pines, FL
- $65,000 - $95,000 a year
- Full-time
- Mid-level
- Office
- Leadership
- Paid time off
- Opportunities for advancement
Quick Apply
Associate Account Manager
Acrisure South Insurance Services, LLC —Miami Lakes, FL
- Full-time
- Mid-level
- Office
- Administrative experience
- Commuter assistance
- Paid parental leave
Commercial Lines Account Manager
Impact Performance Team —Miami, FL
- $75,000 - $100,000 a year
- Full-time
- Hybrid work
- Mid-level
- Office
- 3 years
- Disability insurance
- Health insurance
Quick Apply
Automotive Finance Manager
Murgado Automotive Group —Miami, FL
- Full-time
- Clean driving record
- Dealership
- Customer service
- Paid holidays
- Health insurance
Quick Apply
Commercial Lines Sales Manager - Florida
Arbol —Miami, FL
- $100,000 - $140,000 a year
- Full-time
- Remote
- Clean driving record
- Office
- Driver's License
- Health insurance
- Dental insurance
Quick Apply

I want to receive the latest job alert for insurance manager in south miami, fl

By signing in to your account, you agree to SimplyHired's Terms of Service and consent to our Cookie and Privacy Policy.

Explore jobs in more locations

insurance manager jobs near south miami, fl

Healthcare Claims and Fee for Service Supervisor

Provider Network Solutions LLC -
Miami, FL

Quick Apply

Job Details

Full-time
$63,000 - $65,000 a year
12 days ago

Qualifications

X12 EDI
Healthcare dispute resolution
Staff supervision
Process audits
EDI
Medicare
Team supervision
Medicare coding guidelines
Payment processing
Standard Operating Procedures (SOPs) implementation
Insurance dispute resolution
Overseeing healthcare denial management
Coaching
CMS
Regulatory compliance in claims processing
AI tools proficiency
HIPAA
Performance management
Medical claims processing software
CMS regulatory compliance
Policy & process development
Health insurance knowledge
Medicare regulations
Decision making
System testing
Payment posting in medical billing systems
Technical writing
Interdisciplinary policy and procedure development experience
Insurance investigations
Centers for Medicare & Medicaid Services (CMS) billing regulations

Full Job Description

Description:

Position Summary

The Claims and Fee for Service Supervisor manages the operational activities and staff of the Claims and Revenue Cycle Department in accordance with the Company guidelines, client needs, and State and Federal requirements.

Duties and Responsibilities

Oversee and manage daily activities and functions of the Claims Examiners processing claims for services that are capitated and Fee for Service with the health plan.
Responsible for overseeing the Revenue Cycle Management and Claims department’s daily operations, including but not limited to, running daily/frequent reports to ensure claims are processed timely, accurately, and in compliance with all federal and state healthcare plan laws and regulations. As well as, posting of all 835 payments.
Develop, implement, and update Claims Policies and Procedures to ensure compliance with CMS, Medicaid, HIPPA regulations, and health plan requirements.
Report overpayments, underpayments, and other irregularities.
Manage and close out claims open tickets and provider claims disputes.
Ensure optimal handling of all claims, investigate claims issues, and provide claims training for all business units.
Work together with Provider Servicing and participate in provider education, as necessary.
Maintain a fully comprehensive understanding of the covered benefits, coding, and reimbursement policies and contracts.
Act as Subject Matter Expert in issues related to claims processing, payment dispute resolution, cost containment, audit processes, and contract interpretation.
Actively collaborate with management and staff to ensure that “best practices” are followed and continually seek efficient and innovative processes, technologies, and approaches to optimize the use of resources and enhance operations.
Conduct analysis around various claims payment processes to ensure accuracy of system configuration and provider payments.
Investigate and resolve problem claims, while focusing on improving errors and problems to prevent future occurrences.
Perform and execute various claims process testing requests to ensure desired results are met to support accurate claims payments.
Analyze and adjudicate complex claims when examiner is requesting Supervisor review.
Adjudicate claims by, including but not limited to, applying medical necessity guidelines, determining coverage and completing eligibility verification, identifying discrepancies and applying all cost containment measures when necessary.
Process medical claims by approving or denying documentation, calculating benefits due initiating a payment or denial letter when necessary.
Follow any center for Medicare and Medicaid (CMS) changes affecting claims processing.
Perform pre-payment audit and payment cycle.
Complies with performance standards as set forth by the department head.
Follow company policies, procedures, and guidelines to ensure legal compliance.
Update claims knowledge by participating in educational opportunities, whether system oriented or medical coding/terminology/interpretation.
Update and maintain departmental and specialty network standards of operating procedure (SOP).
Regularly meet with VP of Operations - to discuss and resolve reimbursement issues or billing obstacles.
Perform one-on-one meeting with the individual staff members.

Requirements:

Knowledge

Bachelor’s degree in health administration, Business, or a related field (or equivalent experience).
5+ years of experience in healthcare claims processing, Revenue Cycle Management, or medical billing; 2+ years in a supervisory or lead role preferred.
Strong understanding of CMS, Medicare, Medicaid, HIPAA, and healthcare compliance standards.
Proficiency with medical coding systems (ICD-10, CPT/HCPCS) and claims adjudication platforms.
Experience with payment posting, audits, dispute resolution, and claims system testing/UAT.
Experience using AI applications to streamline claims processing, improve accuracy in claim evaluations, and enhance decision-making efficiency.

Skills

Analytical & problem-solving skills to resolve complex claims, identify root causes, and ensure accurate payments.
Leadership & supervisory skills for managing daily operations, coaching staff, and conducting performance meetings.
Strong communication abilities to collaborate with providers, internal teams, and senior leadership.
Process & policy development skills, including writing SOPs, implementing best practices, and ensuring regulatory compliance.
Technical proficiency in claims platforms, RCM systems, Excel/reporting, and conducting system/UAT testing.

Quick Apply

Refine Your Search

insurance manager jobs in south miami, fl

Healthcare Claims and Fee for Service Supervisor

Commercial Lines Account Manager

Life Insurance Sales Manager

Insurance Commercial Lines Account Executive - Team Leader

220 Licensed Insurance Sales Store Manager (SIGN ON BONUS)

Fast Track Financial Sales Manager/Partner Local Candidates Only

Automotive Finance Manager

Regional Sales Manager (South Florida)

Personal Lines Account Manager

Account Manager

Finance and Insurance (F&I) Manager

Sales Manager

Legal Office Manager

Account Manager - State Farm Agent Team Member

Client Service Manager

Account Manager - State Farm Agent Team Member

Associate Account Manager

Commercial Lines Account Manager

Automotive Finance Manager

Commercial Lines Sales Manager - Florida

I want to receive the latest job alert for insurance manager in south miami, fl

Related Searches

Explore jobs in more locations

Job Seeker Tools

Employer Tools

Browse

Stay Connected