- Travelers Insurance Company (Orlando, FL)
- …negotiating and resolving assigned General Liability related Bodily Injury and Property Damage claims . Provide quality claim handling throughout the claim ... records and damages documentation. + Keeps effective diary management system to ensure that all claims are...and control legal expenses Assures appropriate resolution. + Maintains claim files, have an effective diary system ,… more
- The Hartford (Lake Mary, FL)
- …and successfully investigating, reserving, recommending and implementing strategies to resolve claims consistent with corporate claim standards, policies and ... execute file strategies including investigation, valuation, disposition and settlement of assigned claims , in a manner consistent with corporate claim settlement… more
- Molina Healthcare (FL)
- …is clear and concise to ensure accuracy in auditing of critical information on claims ensuring adherence to business and system requirements of customers as it ... applied to the appropriate modules within the core processing system (QNXT). * Conducts focal healthcare Medical claim...+ Knowledge of verifying documentation related to updates/changes within claims processing system . + Experience using… 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
- Elevance Health (Tampa, FL)
- **Business Architect Sr. - Claims Systems ** **Location:** This role requires associates to be in-office 1 day per week, fostering collaboration and connectivity, ... as required by law. The **Business Architect Sr. - Claims Systems ** will be part of Elevance...and other claims -based root-cause investigations leveraging intimate claims system and business process knowledge to… more
- Molina Healthcare (Orlando, FL)
- …* Apply previous experience and knowledge to verify accuracy of updates to claim /encounter and/or system update(s) as necessary. * Works with fluctuating volumes ... updates/changes to member enrollment, provider contract, provider demographic information, claim processing guidelines and/or system configuration requirements.… more
- Highmark Health (Tallahassee, FL)
- …and adjudicates claims up to pre-determined dollar threshold. Completes pended claim letters for incomplete, invalid, or missing claim information to TPAs, ... to assess the accuracy of client reports submitted to the organization, efficiency of claim operations, and adequacy of systems and procedures. + Approves … more
- Cognizant (Tallahassee, FL)
- ** Claims Process Executive (remote)** **JOB PURPOSE:** Claim Processors will review claim submissions, verify information, adjudicate the claim as per ... regarding claims issues and research, ensuring accurate and complete claim information, contacting insured or other involved parties for additional or missing… more
- The Hartford (Lake Mary, FL)
- …, ensuring all claim handling meets quality and compliance standards. Manage Claim Files: + Handle assigned claims in a manner consistent with corporate ... and timely reserves. + Manage all aspects of assigned claims , which includes initial claim contact, reserve...adapt to change and to learn and utilize multiple systems to manage claims + Computer literacy… 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