- Sedgwick (Orlando, FL)
- …naturally empathic and solution-focused. **ESSENTIAL RESPONSIBLITIES MAY INCLUDE** + Makes claim determinations to approve non-complex disability claims or makes ... professional needs. **PRIMARY PURPOSE OF THE ROLE:** To process claims and determine benefits due pursuant to a disability...disability offsets; and to ensure the ongoing processing of claims . **ARE YOU AN IDEAL CANDIDATE?** We are looking… more
- City of Coral Gables, FL (Coral Gables, FL)
- …and supports overall risk-management activities. The role manages workers' compensation claims from first report through closure, partners with internal stakeholders ... and contractual insurance requirements and assists with all risk related liability claims . Job Duties and Responsibilities The following duties are normal for this… more
- MyFlorida (Tallahassee, FL)
- …additional claims . This is accomplished through tracking the assigned claim load and utilizing the benefit payment system. Track assignments for ... to apply the law in making initial determinations on claims . The individual in this position must be able...relative to the information submitted. Ensures that documentation of claim records is maintained and available to the Office… more
- Molina Healthcare (FL)
- …and executing operational initiatives tied to Payment Integrity (PI) and provider claims accuracy. The individual will be relied upon to make independent, informed ... for all PI solutions. + Lead efforts to improve claim payment accuracy, claim referrals, adjustment analysis...a business lens to ensure accurate interpretation of provider claims trends, payment integrity issues, and process gaps. +… more
- Sedgwick (Miami, FL)
- …develops colleagues, identifies, and manages needed training, and monitors individual claim activities for trends and improvements; provides guidance and support in ... compliance and client policies. Provides guidance on questions from auditors, reviews claim audit information to determine if findings occurred and advises on… more
- Kemper (Lake Mary, FL)
- …attorney represented injury claims , complex injury claims , and litigated claims . The Litigation Specialist will have advanced claim handling skills and ... **Position Responsibilities:** + Successfully handle any complex coverage or liability claims investigation. + Evaluate complex injury claims and determine… more
- The Hartford (Lake Mary, FL)
- …too. Join our team as we help shape the future. The Liability Claim Performance Analytics group is seeking a Performance Analytics Consultant to support operational ... of key processes, continuous improvement initiatives, and changes in trends in Claims . The individual will perform diagnostic analytics to identify underlying causes… more
- Sedgwick (Miami, FL)
- …claimants, and physicians. + Provides effective explanations of benefits, procedures, claim status, or payment information to clients and claimants. + Enters ... claims data into claims management system upon requesting the appropriate information and analyzing the responses. + Requests physician certification and/or… more
- Molina Healthcare (St. Petersburg, FL)
- …and financial outcomes for all PI solutions. + Leads efforts to improve claim payment accuracy, claim referrals, adjustment analysis and financial performance ... Analysis** + Uses a business lens to ensure accurate interpretation of provider claims trends, payment integrity issues, and process gaps. + Applies understanding of… more
- Sedgwick (Miami, FL)
- …Defect **PRIMARY PURPOSE** **:** To investigate and adjust property and casualty claims , both residential and commercial, with little to no supervision. **ESSENTIAL ... FUNCTIONS and RESPONSIBILITIES** + Inspects claims and contacts involved parties in a timely manner....parties in a timely manner. + Investigates circumstances of claim (s) as required for coverage determination, cause, and compensable… more