• Claims Examiner II

    DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
    …+ Excellent oral and written communication skills + 1 - 3 years of Health claims processing experience + Working knowledge of COB and MSP preferably + Medical ... Claims Examiner is responsible for providing expertise and/or claims support in reviewing, researching, investigating, processing ...Ensure that the proper benefits are applied to the claim using the appropriate tools (eg CMS guidelines) +… more
    DOCTORS HEALTHCARE PLANS, INC. (08/08/25)
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  • Director, Initial Claims

    Humana (Tallahassee, FL)
    …Initial Claims has oversight of and drives for continuous improvement in initial claims processing for all medical lines of business. The role will focus on ... and offshore support + Monitors performance and operational reporting in the Claims Processing space, with regular executive summary roll-up to leadership… more
    Humana (08/09/25)
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  • Medical Insurance Claims Specialist

    HCA Healthcare (Port Charlotte, FL)
    …As an **Insurance Follow up Representative** , you will be responsible for processing insurance accounts to address claim issues and thereby affect payment ... organization that invests in you as a Medical Insurance Claims Specialist? At Parallon, you come first. HCA Healthcare...difference. We are looking for a dedicated Medical Insurance Claims Specialist like you to be a part of… more
    HCA Healthcare (08/09/25)
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  • Claims Processor

    TEKsystems (Daytona Beach, FL)
    Claims Processor Daytona Beach, FL 32114 Pay Rate:... on their homeowner's insurance. + Manages the loss claim from the point of reporting through completion of ... quickly and accurately. + All activity pertaining to the claim must be documented and draws are issued for...draws are issued for the repairs as needed. + Processing must meet all compliance requirements. + Demonstrate the… more
    TEKsystems (08/09/25)
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  • Claims and Call Auditor (Call Center QC)

    CHS (Clearwater, FL)
    …guidelines, and reporting requirements; Federal and state regulations; and timeliness of claims processing . + Utilize Excel, prepares tracking and trending ... up-to-date working knowledge on regulatory requirements associated with billing and claims processing , as well as HIPAA guidelines/established Encryption… more
    CHS (06/14/25)
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  • Lead Claims Processor, Government Programs

    Prime Therapeutics (Tallahassee, FL)
    …or submit claims and adjustments as required. + Implementation and maintenance of claims processing programs and procedures + Verify that claims are ... our passion and drives every decision we make. **Job Posting Title** Lead Claims Processor, Government Programs **Job Description** Adjudicate or submit claims more
    Prime Therapeutics (07/29/25)
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  • Patient Claims Specialist

    Modernizing Medicine (Tampa, FL)
    …for all inbound and outbound patient calls regarding patient balance inquiries, claims processing , insurance updates, and payment collections + Initiate outbound ... the US, Chile, and Germany. ModMed (https://www.modmed.com/company/) is hiring a driven Patient Claim Specialist who will play a pivotal role in shaping a positive… more
    Modernizing Medicine (08/08/25)
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  • Payment Claims Analyst

    Aston Carter (Deerfield Beach, FL)
    The Claims Payment Analyst is responsible for reviewing, analyzing, and processing claims payment requests for automotive repairs. The individual will ... to internal policies and procedures. Responsibilities + Review and process claims payment requests for automotive repairs. + Determine the appropriate payment… more
    Aston Carter (08/08/25)
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  • Claims Specialist, Audit & Contracting

    LogixHealth (Dania, FL)
    Location: On-Site in Dania, FL This Role: As a Claims Specialist, you will work with internal teams to provide cutting-edge solutions that will directly improve the ... and carry out processes on all out of network claims . The ideal candidate will have strong technological skills,...+ Ability to create routine reports + Prior word processing , spreadsheet and internet software experience including p roficiency… more
    LogixHealth (07/11/25)
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  • Executive Director, Business and Data Analytics…

    USAA (Tampa, FL)
    …and implementation of multiple Data and Analytics sub-functions for Claims that may include: Information Strategy and Architecture, Information Management, ... and long-term strategy and vision of the assigned sub-functions for the CoSA Claims working with peers to set objectives across the different sub-functions that… more
    USAA (08/08/25)
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