- Publix (Lakeland, FL)
- **33789BR** **Position Title:** PROFIT Plan Claims Processing Specialist, Retirement - Lakeland **Department:** Benefits Administration **Location:** Lakeland, ... System + 2 years retirement related experience and 2 years of claims processing experience, or 4 years customer service experience in retirement related field… more
- Molina Healthcare (St. Petersburg, FL)
- …appeal has been submitted, to ensure medical necessity and appropriate/accurate billing and claims processing . + Identifies and reports quality of care issues. + ... to providers. **Job Duties** + Performs clinical/medical reviews of retrospective medical claim reviews, medical claims and previously denied cases, in which… more
- Sedgwick (Tallahassee, FL)
- … by investigating and gathering information to determine the exposure on the claim ; manages claims through well-developed action plans to an appropriate and ... and provides report of investigation pertaining to new events, claims and legal actions. + Negotiates claim ...depositions, mediations, and trial monitoring as needed. + Communicates claim activity and processing with the client;… more
- Molina Healthcare (Jacksonville, FL)
- …Contracted Provider disputes and appeals to ensure adherence with Molina claims processing standards and provider contractual agreements. Includes responsibility ... from start to finish of the claim disputes to include intake, processing , decisioning,...IPA. + 2 years supervisory/management experience with appeals/grievance and/or claims processing within a managed care setting.… more
- Sedgwick (Tallahassee, FL)
- … by investigating and gathering information to determine the exposure on the claim ; manages claims through well-developed action plans to an appropriate and ... including strategic vendor partnerships to reduce overall cost of claims for our clients. + Manages claim ...directions in a professional and timely manner. + Communicates claim activity and processing with the claimant… more
- City of Jacksonville (Jacksonville, FL)
- …records and bills; analyzes city, state, and federal documents for liability claims and establishes claim value. + Makes decisions determining settlements, ... settlement values, payment processing or denial of claims utilizing knowledge...and federal statutes as they apply to a particular claim . + Attends and participates in depositions and mediations;… more
- Cognizant (Tallahassee, FL)
- …Monday to Friday 8am - 4:30pm ET **Experience:** A minimum of 1 years claims processing is required. **Travel:** None required **About the role:** As ... * Be Responsible for reviewing the data in the claim processing system and comparing with corresponding...to be considered:** * A minimum of 1 year claims processing is required. * Knowledge of… more
- Sedgwick (Tallahassee, FL)
- …FUNCTIONS and RESPONSIBILITIES** + Processes complex auto commercial and personal line claims , including bodily injury and ensures claim files are properly ... and risk transfer opportunities; secures and disposes of salvage. + Communicates claim action/ processing with insured, client, and agent or broker when… more
- Sedgwick (Tallahassee, FL)
- …. + Negotiating settlement of claims within designated authority. + Communicating claim activity and processing with the claimant and the client. + Reporting ... client service requirements. **ESSENTIAL RESPONSIBLITIES MAY INCLUDE** + Analyzing and processing claims through well-developed action plans to an appropriate… more
- TEKsystems (Deerfield Beach, FL)
- …stability, and excellent benefits, we encourage you to apply. Key Responsibilities + Claims Evaluation & Processing + Use your automotive knowledge to assess ... Mechanical Claims Specialist - Job Description Are you an...mechanical claims for accuracy and coverage. + Determine ... claims for accuracy and coverage. + Determine claim outcomes based on established guidelines and warranty terms.… more