- Sedgwick (Orlando, FL)
- … for multiple lines of business, including but not limited to, expediting the claims process, and providing detailed claim notes on all calls, resolving issues ... for this or other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The… more
- Sedgwick (Orlando, FL)
- …payments and/or adjustments for client paid leave plans ensuring that on-going claim management is within company service standards and industry best practices. ... and solution-focused. **ESSENTIAL RESPONSIBLITIES MAY INCLUDE** + Establishes FMLA claims ; tracks and codes documentation in accordance with internal workflow… more
- Northwest Florida Community Hospital (Chipley, FL)
- …+ Demonstrates up-to-date knowledge related to CMS guidelines, ICD-10 requirements, UB/1500 claim submission data and elements required for clean claim ... processes occur. + Ability to analyze and resolve problems that affect the claim submission process, regardless of whether the problem originates in an area under… more
- Ankura (Miami, FL)
- …in research and analysis project cost records and financial statements + Reconcile claim amounts to accounting systems and to insurers' calculations + Use Ankura's ... proprietary tools and industry standards in the development of claim methodology and work product + Develop computer models of schedules, contractor production rates… more
- CVS Health (Tallahassee, FL)
- …a highly skilled and experienced Senior Product Owner to join our Commercial Claim Adjudication engineering team. As a Senior Product Owner, you will contribute to ... by: + Leading the development and enhancement of Commercial Claim products or services. + Conducting market research. +...market trends to help drive the success of Commercial Claim products and ensure they meet customer needs and… more
- USAA (Tampa, FL)
- …you will be responsible to adjust attorney-involved, moderately complex UM/UIM claims or moderately complex to include confirming coverage, determining liability, ... investigating, evaluating, negotiating, and adjudicating claims in compliance with state laws and regulations. Responsible for delivering a concierge level of… more
- USAA (Tampa, FL)
- …As a dedicated Complex Auto Adjuster, you will adjust highly complex auto insurance claims presented by or against our members to include the end-to-end claims ... and physical damage including total loss settlements for highly complex auto claims . + Negotiates liability for comparative negligence (claimant or adverse carrier).… more
- USAA (Tampa, FL)
- …**Injury Examiner** , you will be responsible to adjust complex bodily injury claims , UM/UIM, and small business claims to include confirming coverage, ... determining liability, investigating, evaluating, negotiating, and adjudicating claims in compliance with state laws and regulations. Responsible for delivering a… more
- ICW Group (Orlando, FL)
- …**PURPOSE OF THE JOB** The purpose of this job is to supervise functions of claims internal controls and to monitor team activities with a focus on trends and ... This position is responsible for the development and execution of the Claims audit program, identifying trends and promoting continuous improvement. This role exists… more
- HCA Healthcare (Ocala, FL)
- …relates to researching, analyzing, and resolving outstanding clinical denials and insurance claims . This job requires regular outreach to payors and Practices. **In ... telephonically + Overcome objections that prevent payment of the claim and gain commitment for payment through concise and...+ Update patient accounts as appropriate + Submit uncollectible claims for adjustment timely and correctly + Resolve … more