• Medical Claims Examiner

    CHS (Clearwater, FL)
    **Overview** **Health Insurance Medical Claims Examiner ** **Monday-Friday Schedule with daytime hours** **Responsibilities** **Summary:** The Medical Claims ... guidelines. **Essential Duties and Responsibilities:** + Reviews and adjudicates medical claims based on health policy provisions and established guidelines +… more
    CHS (08/08/25)
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  • Claims Examiner II

    DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
    Position Purpose: The Claims Examiner is responsible for providing expertise and/or claims support in reviewing, researching, investigating, processing and ... adjusting claims and other duties as necessary. Key Responsibilities: +...Ensure that the proper benefits are applied to the claim using the appropriate tools (eg CMS guidelines) +… more
    DOCTORS HEALTHCARE PLANS, INC. (08/23/25)
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  • Financial Examiner /Analyst II

    MyFlorida (Tallahassee, FL)
    FINANCIAL EXAMINER /ANALYST II - 42005562 Date: Aug 25, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify ... No: 859292 Agency: Agriculture and Consumer Services Working Title: FINANCIAL EXAMINER /ANALYST II - 42005562 Pay Plan: Career Service Position Number: 42005562… more
    MyFlorida (08/26/25)
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  • Medical Disability Examiner

    MyFlorida (Tallahassee, FL)
    …any follow-up correspondence regarding the hiring process for this ad. TITLE: CLAIMS ADJUSTERS, EXAMINERS AND INVESTIGATORS MEDICAL DISABILITY EXAMINER POSITION ... MEDICAL DISABILITY EXAMINER - 64083389 Date: Aug 20, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify Website… more
    MyFlorida (08/22/25)
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  • Financial Examiner /Analyst I

    MyFlorida (Tallahassee, FL)
    FINANCIAL EXAMINER /ANALYST I - 43004865 Date: Aug 19, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify Website ... . Requisition No: 849175 Agency: Financial Services Working Title: FINANCIAL EXAMINER /ANALYST I - 43004865 Pay Plan: Career Service Position Number: 43004865… more
    MyFlorida (08/19/25)
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  • Specialist, Configuration Oversight (Healthcare…

    Molina Healthcare (Orlando, FL)
    …is clear and concise to ensure accuracy in auditing of critical information on claims ensuring adherence to business and system requirements of customers as it ... written and verbal + Knowledge of verifying documentation related to updates/changes within claims processing system . + Experience using claims processing… more
    Molina Healthcare (08/16/25)
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  • Claims Manager

    CHS (Clearwater, FL)
    **Overview** ** Claims Manager** **Servicing** **Health Insurance Policies or Benefits** **Summary:** Premier Administrative Solutions (PAS) is a Third-Party ... organizations, insurance marketing organizations, and employers. One core service, claims administration, is where submissions for payment/reimbursement/sharing from medical… more
    CHS (08/08/25)
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  • Telephonic Case Manager

    Sedgwick (Tallahassee, FL)
    …support systems . + Effectively communicates and builds relationships with the claims ' examiner , client, injured worker, attorney and supervisor. + Identifies ... recovery. + Provides recommendations for alternate clinical resources to support claim resolution. + Maintains client's privacy and confidentiality, promotes client… more
    Sedgwick (08/23/25)
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  • Physician (Primary Care)

    Veterans Affairs, Veterans Health Administration (Cape Coral, FL)
    …physician to assigned physicians and NP/PAs. Performs expanded single organ/ system compensation and pension exams as indicated. Requests consultations and/or ... clinical background. Preferred experience as Medical Review Officer, Certified medical examiner for commercial motor vehicle drivers, and certification as an… more
    Veterans Affairs, Veterans Health Administration (06/14/25)
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  • Health Insurance Fraud Analyst II

    MyFlorida (Tallahassee, FL)
    …INSURANCE FRAUD ANALYST II - 72004150 Date: Aug 19, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify Website ... design and implement algorithms to effectively data-mine within various types of claims data utilizing a variety of software applications; compile research, data… more
    MyFlorida (08/20/25)
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