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Since 1984, Florida Cancer Specialists & Research Institute (FCS) has built a national reputation for excellence. With over 250 physicians, 220 nurse practitioners and physician assistants and nearly 100 locations in our network. Utilizing innovative clinical research, cutting-edge technologies, and advanced treatments, we are committed to providing world-class cancer care. Recognized by the American Society of Clinical Oncology (ASCO) with a national Clinical Trials Participation Award. Offers patients access to more clinical trials than any private oncology practice in Florida. Patients have access to ground-breaking therapies in a community setting. Partnership with Sarah Cannon, one of the largest clinical research organizations in the United States.
Claims Resolution Specialist I
Location
United States
Posted
107 days ago
Salary
0
No structured requirement data.
Job Description
Claims Resolution Specialist I
Florida Cancer Specialists
Date Posted: 2026-01-26Country: United States of AmericaLocation: Florida - Remote WHY JOIN FCS At Florida Cancer Specialists & Research Institute, we believe our people are our strength and we invest in them. In addition to having a positive impact on the people and communities we serve, associates benefit from significant professional opportunities, career advancement, training and competitive wages. Offering competitive salaries and comprehensive benefits packages to include tuition reimbursement, 401-K match, pet and legal insurance. A LITTLE BIT ABOUT FCS Since 1984, Florida Cancer Specialists & Research Institute & Research Institute (FCS) has built a national reputation for excellence. With over 250 physicians, 220 nurse practitioners and physician assistants and nearly 100 locations in our network. Utilizing innovative clinical research, cutting-edge technologies, and advanced treatments, we are committed to providing world-class cancer care. We are recognized by the American Society of Clinical Oncology (ASCO) with a national Clinical Trials Participation Award, FCS offers patients access to more clinical trials than any private oncology practice in Florida. Our patients have access to ground-breaking therapies, in a community setting, and may participate in national clinical research studies of drugs and treatment protocols. In the past five years, the majority of new cancer drugs approved for use in the U.S. were studied in clinical trials with FCS participation prior to approval. Through our partnership with Sarah Cannon, we are one of the largest clinical research organizations in the United States. Often, FCS leads the nation in initiating research studies and offering ground-breaking new therapies to patients. Come join us today! RESPONSIBILITIES - Position Summary: Review all medical insurance claims for resolution and payment. - Resolve any incoming inquiries or payment denials from insurance providers for payment. Research, compile, and respond to documentation requests from insurance carriers in a timely basis. - Contact insurance carriers to collect on open account balances. QUALIFICATIONS - Required Qualifications: - The Claims Resolution Specialist must have excellent knowledge of insurance carrier billing and reimbursement with knowledge of medical terminology, ICD-9, and CPT codes. - Must have an in-depth understanding of explanation of benefits (EOB) - At least one year of prior medical billing or medical collections experience. - EMR or GE Centricity Practice Management software experience preferred. - Medical Oncology, Radiology, Radiation, Laboratory, or Pathology experience preferred. - Excellent communication and interpersonal skills required. Remote: YES Normal Schedule: Monday - Friday 8am - 5pm EST #LI-AH1 SCREENINGS – Background, drug, and nicotine screens Safeguarding our patients and each other is an important part of how we deliver the best care possible to the communities we serve. All offers of employment at Florida Cancer Specialists & Research Institute are contingent upon clear results of a thorough background screening. Additionally, as a condition of employment, FCS requires all new hires to receive various vaccinations, including the influenza vaccine, barring an approved exemption. In addition, FCS is a drug-free workplace, and all new hires will be subject to drug/ nicotine testing. Medical Marijuana cards are not recognized. EEOC Florida Cancer Specialists & Research Institute (FCS) is committed to helping individuals with disabilities to participate in the workforce and ensure equal opportunity to compete for jobs. If you require an accommodation to submit a resume for positions at FCS, please email FCS Recruitment (Recruiter@FLCancer.com) for further assistance. Please note this email address is intended to request an accommodation as part of the application process. Any other correspondence will not receive a response. FCS is an EEO/Affirmative Action Employer and does not discriminate on the basis of age, race, color, religion, gender, sexual orientation, gender identity, gender expression, national origin, protected veteran status, disability or any other legally protected status.
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We are a hybrid, remote-office company dedicated to growing our talent anywhere! We have onsite locations in: Sioux Falls, SD, Scottsdale, AZ, Louisville, KY, Troy, MI, Franklin, TN, Easton, PA. At Pathward, we take tremendous pride in our purpose to create financial inclusion for all™. We are a financial empowerment company that works with innovators to increase financial availability, choice, and opportunity for all. We strive to remove barriers that traditional institutions put in the way of financial access, and promote economic mobility by providing responsible, secure, high quality financial products. We are a team of problem solvers and innovators who celebrate our differences and know that our unique perspectives make us stronger and well-positioned for success. 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We provide equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, ethnicity, religion, sex, sexual orientation, gender identity, transgender status, pregnancy, national origin, age (age 40 and over), disability, genetic information, marital status, hair texture or hairstyle, ancestry, service in the uniformed services, protected veteran status, status as a victim of domestic violence or any other class protected by federal, state and local laws. Please click here to learn more about our benefits and review information about our Privacy Policy, Affirmative Action Plan and other notices. Applicants with disabilities may be entitled to reasonable accommodation under the terms of the Americans with Disabilities Act and certain state or local laws. 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At Allstate, great things happen when our people work together to protect families and their belongings from life’s uncertainties. And for more than 90 years, our innovative drive has kept us a step ahead of our customers’ evolving needs. From advocating for seat belts, air bags and graduated driving laws, to being an industry leader in pricing sophistication, telematics, and, more recently, device and identity protection. Job Description Under general supervision, the Quick Foto Claims Auto Adjuster is responsible for providing a superior level of customer service and attention to customers who have a vehicle that needs repaired. The individual inspects vehicle damage from photos, writes damage repair estimates, negotiates basic and occasionally moderately complex settlements with repair facilities, and estimates repair times for rental/loss of use. 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This poster summarizing the major provisions of the Family and Medical Leave Act (FMLA) and telling employees how to file a complaint. It is the Company’s policy to employ the best qualified individuals available for all jobs. Therefore, any discriminatory action taken on account of an employee’s ancestry, age, color, disability, genetic information, gender, gender identity, gender expression, sexual and reproductive health decision, marital status, medical condition, military or veteran status, national origin, race (include traits historically associated with race, including, but not limited to, hair texture and protective hairstyles), religion (including religious dress), sex, or sexual orientation that adversely affects an employee's terms or conditions of employment is prohibited. 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Property Claims Analyst
Encova InsuranceEncova Insurance provides commercial, auto and home insurance.
The salary range for this job posting is $69,152.00 - $110,642.00 annually + bonus + benefits. Pay Type: Salary The above represents the full salary range for this job requisition. Ultimately, in determining your pay and job title, we'll consider your location, education, experience, and other job-related factors, and will fall within the stated range. Your recruiter can share more information about the specific salary range during the hiring process. Encova Insurance is seeking a Property Claims Analyst. This role will have the option to work a home-based schedule, but you must reside in Ohio. Are you a Referral? If you know a current Encova Insurance associate and would like to apply as a referral, please encourage them to submit your referral information before you submit your application. You will receive an email with a direct URL link to the Job Posting of interest. Applying through this URL link will create your referral relationship for our Talent Acquisition Team. 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Join us and thrive both professionally and personally. Encova Insurance is an EOE/E-Verify employer. #LI-Remote#LI-LP1
Government Programs Professional Review Claims Specialist
Delta DentalEstablished in 1957, Delta Dental of Michigan is a prominent division of the Delta Dental Plans Association, providing dental benefits to millions across the Un
Job Title: Government Programs Professional Review Claims Specialist Number of Positions: 1 Location: Okemos, MI Location Specifics: Fully Remote Job Summary: Candidates must reside within a reasonable commuting distance of our Okemos, MI office for team meetings, collaborative sessions, and training. At Delta Dental of Michigan, Ohio, and Indiana we work to improve oral health through benefit plans, advocacy and community support, and we amplify this mission by investing in initiatives that build healthy, smart, vibrant communities. We are one of the largest dental plan administrators in the country, and are part of the Delta Dental Plans Association, which operates two of the largest dental networks in the nation. At Delta Dental, we celebrate our All In culture. It’s a mindset, feeling and attitude we wrap around all that we do – from taking charge of our careers, to helping colleagues and lending a hand in the community. Position Description To analyze and adjudicate dental claims with complicated treatment plans to ensure accurate benefits administration. Primary Job Responsibilities - Analyzes and processes dental claims so appropriate determinations can be finalized with correct procedures, policies, and bypasses; adjudicates claims, and maintains claim records. - Administers claim processing guidelines/standards, Delta USA processing policies, group contracts, provider agreements, and state laws applicable to claims adjudication. - Investigates difficult provider reconsideration requests, makes determinations, performs or coordinates adjustments; prepares claims for a second and/or third opinion when necessary and consults with contracted dentists on questionable treatment cases. - Pre and post-screens claims and/or inquiries for dental consultant(s); reviews and prepares claims for and coordinates external dental consultant activities. - Provides dental expertise and/or interpretation of dental policies, procedures codes, and processing guidelines to internal and external contacts. - Organizes, creates, and performs defined test cases on claims processing system, and documents/reports status of testing including recommendations for improvements. Analyzes and compiles information/data for reports to control and/or monitor claims inventory. - Researches, coordinates, and adjudicates Third Party Liability claims and recoveries; compares member information, prepares claims, and performs adjustments as necessary to ensure proper Third Party Liability (COB) adjudication. Perform other related assigned duties as necessary to complete the Primary Job Responsibilities as described above. #LI-Remote Minimum Requirements: Position requires an associate's degree, technical, vocational, or business school with coursework related to dentistry, two years of experience in chair side assisting, and a RDA or RDH licensure. Will accept any suitable combination of education, training, or experience. Position requires advanced knowledge of dental terminology and dental procedures and the ability to read and interpret radiographs, electronic images and photos; experience working with word processing and spreadsheet software; effective verbal and written communication skills; ability to resolve complex problems and use independent judgment; experience with provider system; client contracts and Roosevelt is preferred. The company will provide equal employment and advancement opportunity within the context of its unique business environment without regard to race, color, religion, gender, gender identity, gender expression, age, national origin, familial status, citizenship, genetic information, disability, sex, sexual orientation, marital status, pregnancy, height, weight, military status, or any other status protected under federal, state, or local law or ordinance.

