• Claims Specialist, Sr. Medical Malpractice…

    Sedgwick (Orlando, 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 ...coding is correct. + Refers cases as appropriate to supervisor and management. + Delegates work and mentors assigned… more
    Sedgwick (08/29/25)
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  • Claims Specialist Sr - Commercial Coverage…

    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 ...coding is correct. + Refers cases as appropriate to supervisor and management. + Delegates work and mentors assigned… more
    Sedgwick (07/10/25)
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  • Claims Examiner | General Liability…

    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 ...coding is correct. + Refers cases as appropriate to supervisor and management. **ADDITIONAL FUNCTIONS and RESPONSIBILITIES** + Performs… more
    Sedgwick (08/27/25)
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  • Claims Examiner Workers Comp I Remote I SE,…

    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 ...coding is correct. + Refers cases as appropriate to supervisor and management. **ADDITIONAL FUNCTIONS and RESPONSIBILITIES** + Performs… more
    Sedgwick (06/29/25)
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  • Claims Team Lead, General Liability

    Sedgwick (Tallahassee, FL)
    …of education and experience required to include two (2) years of claims supervisor experience. **SUPERVISORY RESPONSIBILITIES** + Performs other duties as ... Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Team Lead, General Liability **PRIMARY PURPOSE** : To...claim status; and provides written resumes on specific claims as requested by client. + Maintains frequent diaries… more
    Sedgwick (08/22/25)
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  • Claims Team Lead I Workers Comp (Calif Exp)

    Sedgwick (Tallahassee, FL)
    …equivalent combination of education and experience required to include two (2) years claims supervisor experience. **Skills & Knowledge** + Thorough knowledge of ... Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Team Lead I Workers Comp (Calif Exp) **PRIMARY...claim status; and provides written resumes of specific claims as requested by client. + Assures that direct… more
    Sedgwick (08/23/25)
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  • Claims Manager

    CHS (Clearwater, FL)
    …and financial accuracy percentages. * Coordinating escalations from other Departments with the Claims Supervisor to ensure that timely and complete actions and ... **Overview** ** Claims Manager** **Servicing** **Health Insurance Policies or Benefits**...Establishing production requirements for Examiners, and along with the Supervisor monitoring performance against the requirements. * Establishing and… more
    CHS (08/08/25)
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  • Lead Adjudicator, Provider Claims

    Molina Healthcare (Miami, FL)
    … claims adjusting and customer services experience Experience in QNXT, Salesforce, Claims Viewer, Claim Shark, PEGA, Cotiviti, ECHO, CEMs Edifecs **PHYSICAL ... Description** **Job Summary** Responsible for work load assignment to the provider Claims adjudicators and senior provider claims adjudicators. Train and coach… more
    Molina Healthcare (08/28/25)
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  • Claims and Call Auditor (Call Center QC)

    CHS (Clearwater, FL)
    **Overview** ** ** ** Claims and Call Auditor (Call Center QC) - Clearwater, FL** ** ** **Summary** The Claims & Call Auditor audits processed medical insurance ... medical audits, target audits, re-audits, etc and audits for claims which are in excess of payment authority limits...with accuracy, and work with the MPS Call Center Manager/ Supervisor /Team Lead and analyze the data for training purposes.… more
    CHS (06/14/25)
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  • Manager, Claims Modernization, Reporting…

    Healthfirst (FL)
    …+ Recommend business controls to improve business results + Partner with supervisor and peers to establish goals, priorities and deliverables of Business/ Project ... as performance of the Business/Project Analyst team. + Regularly meet with supervisor , peers, and stakeholders to drive high performance results. + Collaborate… more
    Healthfirst (08/14/25)
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