- The Hartford (Lake Mary, FL)
- …and successfully investigating, reserving, recommending and implementing strategies to resolve claims consistent with corporate claim standards, policies and ... strategies including investigation, valuation, disposition and settlement of assigned claims , in a manner consistent with corporate claim...within the US and work their own time zone hours . Start Date: Open Hours : 8:00 AM-… more
- Molina Healthcare (FL)
- **Job Description** **Work hours will be 7am-3:30pm PST M-F** **Job Summary** Responsible for conducting various healthcare Healthcare claim audits including, ... clear and concise to ensure accuracy in auditing of critical information on claims ensuring adherence to business and system requirements of customers as it pertains… more
- CVS Health (FL)
- …day. **Position Summary** Reviews and adjudicates complex, sensitive, and/or specialized claims in accordance with plan processing guidelines. Acts as a subject ... customer service inquiries and problems. **Additional Responsibilities:** Reviews pre-specified claims or claims that exceed specialist adjudication authority… more
- Molina Healthcare (Tampa, FL)
- …to providers. **Job Duties** + Performs clinical/medical reviews of retrospective medical claim reviews, medical claims and previously denied cases, in which ... United States. Work Schedule Monday to Friday - operation hours 6 AM to 6 PM (Team will work...schedule) Looking for a RN with experience with appeals, claims review, and medical coding. **Job Summary** Utilizing clinical… more
- AssistRx (Orlando, FL)
- … reimbursement, Sites of Care and Health Care Providers. The Copay Support/ Claims Processing Specialist will adjudication, troubleshoot claim rejections, ... teams on enrollment discrepancies (missing info and duplicates) + Partners with claim adjudication vendors ensure proper claims processing and data integrity.… more
- Cognizant (Tallahassee, FL)
- …regarding claims issues and research, ensuring accurate and complete claim information, contacting insured or other involved parties for additional or missing ... 6 weeks. This is a work-from-home position with day hours , and no travel is required. This position requires...information, and updating information to claim file about claims … more
- CRC Insurance Services, Inc. (FL)
- …of America) **Please review the following job description:** A Complex Claims Manager - Construction Defect and Environmental is responsible for investigating, ... evaluating, and resolving insurance claims related to environmental damage, as well as ...precedents, and environmental regulations. + Calculate and assign appropriate claim reserves based on the potential damages and liability… more
- IQVIA (Miami, FL)
- …responsible for receiving medical claims from HCPs or patients and vetting the claim against program specific business rules to determine if the claim should ... **Patient Support Medical Claims Processing Representative** _Contract Remote Role - Location...documentation has been provided, interpreting the EOB/CMS1500, vetting the claim against program specific business rules and ultimately determining… more
- ICW Group (Orlando, FL)
- …JOB** The purpose of this job is to supervise and provide guidance to the Claims Support staff and to assist in escalated Claims matters. This position exists ... to ensure that Company objectives and standards are met within the Claims Support team. **ESSENTIAL DUTIES AND RESPONSIBILITIES** Manages a claims support unit… more
- CRC Insurance Services, Inc. (FL)
- …accuracy in reporting. Audit invoices for accuracy. 5. Process incoming and outgoing claims and vendor payments. 6. Perform claim status requests and updates. ... following job description:** Responsible for managing and resolving complex insurance claims involving litigation, coverage disputes, and high exposure. This role… more