- Sedgwick (Orlando, FL)
- …General Adjuster - Southeast Region **PRIMARY PURPOSE** **:** To handle losses or claims nationally regardless of size, including having the ability to address any ... Account. **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Examines insurance policies, claims , and other records to determine insurance coverage. + Administers… more
- CVS Health (Tampa, FL)
- …passionate about transforming health care. As the nation's leading health solutions company , we reach millions of Americans through our local presence, digital ... and other IT partners. As part of the AT Claim Organization, you will be responsible for code deliverables...This position also includes an award target in the company 's equity award program. Our people fuel our future.… more
- CVS Health (Tampa, FL)
- …passionate about transforming health care. As the nation's leading health solutions company , we reach millions of Americans through our local presence, digital ... partners, product owners, architecture and other IT partners. As part of the AT Claim Organization, you will be responsible for code deliverables on both long and… more
- Kemper (Doral, FL)
- …knowledge of automobile policies, statutes and trends. + A thorough knowledge of Company claims handling procedures. + Must have excellent communication skills. ... controls litigation within assigned region and ensures that all claims are handled in accordance with established corporate and...the disposal of those cases. + Ensures that uniform claim procedures are used for file handling including compliance… more
- Sedgwick (Tallahassee, FL)
- …Field Case Manager assignment and facilitates initial onsite hospital visit for the claim . + Maintains communication with the customer, Client Service Director, and ... Claims Examiner providing timely updates on changes in injured...which helps clients thrive by navigating the unexpected. The company 's expertise, combined with the most advanced AI-enabled technology… more
- Prime Therapeutics (Tallahassee, FL)
- …to elicit, define, and document the requirements for changes to Prime's claims systems. **Responsibilities** + Ensure understanding of business requirements and IT ... and serve as subject matter expert and mentor for other members of Claims IT team, including cross-training assigned BSAs on system requirements phase of assigned… more
- Sedgwick (Tampa, FL)
- …Rec Marine Adjuster **PRIMARY PURPOSE** **:** To investigate and process marine claims adjustments for clients; to handle complex losses locally unassisted up to ... documentation, and issues settlement. + Receives and reviews new claims and maintains data integrity in the claims...+ Prepares settlement documents and requests payment for the claim and expenses. + Assists in preparing loss experience… more
- Elevance Health (Miami, FL)
- …paid on fraudulent claims . **How you will make an impact:** + Claim reviews for appropriate coding, data mining, entity review, law enforcement referral, and use ... of proprietary data and claim systems for review of... systems for review of facility, professional and pharmacy claims . + Responsible for identifying and developing enterprise-wide specific… more
- Elevance Health (Tampa, FL)
- …in order to recover corporate and client funds paid on fraudulent Medicaid claims . **How You Will Make an Impact:** + Responsible for identifying and developing ... specific healthcare investigations that may impact more than one company health plan, line of business and/or state +... health plan, line of business and/or state + Claim reviews for appropriate coding, data mining, entity review,… more
- Humana (Tallahassee, FL)
- …community and help us put health first** Design and maintain Medicaid claims analytics dataset using Databricks. Conduct in-depth analysis of healthcare claims ... Identify cost drivers, utilization patterns, and anomalies in Medicaid medical claims data. Maintain dashboards to communicate key trends to stakeholders. The… more