- USAA (Tampa, FL)
- …makes us special and impactful. **The Opportunity** As a dedicated **Product Development Manager ** , you will join our New Business Ventures and Innovation team, ... environment, building, and testing new products and capabilities within the auto telematics claims space and helping chart the course for the future of USAA's… more
- USAA (Tampa, FL)
- …us special and impactful. **The Opportunity** As a dedicated **Strategic Account Relationship Manager Senior for Claims Optimization** , you will be responsible ... + Travel may be required. **What sets you apart:** + P&C Claims Operational experience, industry knowledge of contract requirements and experience with oversight… more
- Elevance Health (Tampa, FL)
- **Clinical Documentation and Claims Integrity Director** **Location:** Alternate locations may be considered. This position will work a hybrid model (remote and ... is responsible for leading encounter processing, diagnostic documentation and claims integrity across CareBridge. The ideal candidate has experience working… more
- Healthfirst (FL)
- …within any area of operations (Member Services, Enrollment & Billing, Claims , Provider Services, etc.). + Experience with database reporting and automation, ... budgeting or internal audit processes. + Experience monitoring quality in a reporting and analysis environment. + Experience conducting root-cause analysis and making recommendations based on your findings. + Experience with Tableau, Alteryx, or similar data… more
- CHS (Clearwater, FL)
- …related to claims and calls and provides feedback to their Manager . + Maintains up-to-date working knowledge on regulatory requirements associated with billing ... **Overview** ** ** ** Claims and Call Auditor (Call Center QC) -...with accuracy, and work with the MPS Call Center Manager /Supervisor/Team Lead and analyze the data for training purposes.… more
- USAA (Tampa, FL)
- …you apart:** + Demonstrated P&C Claims technical acumen. + 2+ years Manager Claims Operations experience. + Guidewire ClaimCenter experience. + Familiar with ... We are seeking a dedicated Business Process Owner Senior - Claims User Experience - Claims Optimization. We offer a flexible work environment that requires an… more
- Travelers Insurance Company (Tampa, FL)
- …reserving, negotiating and resolving assigned Construction Defect and Latent Property Damage claims . Provides quality claim handling throughout the claim ... partners. **What Will You Do?** + Directly handles assigned claims . + Provides quality customer service and ensures file...facts or allegations of each case. + Consults with Manager on use of Claim Coverage Counsel… more
- Travelers Insurance Company (Tampa, FL)
- …reserving, negotiating and resolving assigned Construction Defect and latent Property Damage claims . Provides quality claim handling throughout the claim ... **What Will You Do?** + Directly handles assigned severity claims . + Provides quality customer service and ensures quality...facts or allegations of each case. + Consults with Manager on use of Claim Coverage Counsel… more
- Molina Healthcare (Miami, FL)
- …execute effective Payment Integrity strategies through both pre-payment and post payment claims reviews, aligning with industry and corporate standards as well as ... Clinician. This includes assessing medical documentation, itemized bills, and claims data to ensure appropriate payment levels, optimize resource utilization,… more
- Molina Healthcare (FL)
- **Job Description** **Job Summary** The Health Plan Operations, Payment Integrity Program Manager is an individual contributor role designed for a highly capable ... operational initiatives tied to Payment Integrity (PI) and provider claims accuracy. The individual will be relied upon to...for all PI solutions. + Lead efforts to improve claim payment accuracy, claim referrals, adjustment analysis… more