• SIU Investigator

    Kemper (Doral, FL)
    …SIU Investigator will conduct field as well as desk investigations of insurance claims referred to and accepted for investigation by the Special Investigative Unit. ... Miami and surrounding areas. Basic functions include: Investigation of claims , analysis and development of facts and evidence, and...in a thorough timely manner. + Maintains a diary system on all assigned files. Diary system … more
    Kemper (12/05/25)
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  • Surgical Scheduler Coordinator- Carrollwood

    AdventHealth (Wesley Chapel, FL)
    …assisted procedures, reporting the need for updates and corrections for accurate claim submission. Reports any unresolvable practice or system issues resulting ... admission dates, and postoperative days to ensure timely billing of claims . Organizes information needed for appropriate billing, including operative, pathology, and… more
    AdventHealth (01/16/26)
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  • Lead Director, Pharmacy Appeals

    CVS Health (FL)
    …regulatory updates are operationalized. This role requires a thorough knowledge of claim adjudication, internal MAC & non-MAC related processes, and being a leader ... science, and information technology. + Execute process improvements and system enhancements, including coordinating activates across diverse departments and ensure… more
    CVS Health (01/16/26)
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  • Billing Specialist

    HCA Healthcare (Pensacola, FL)
    …apply now. What you will do in this role: + You will transmit claims to billing vendors, process/ correct insurance rejects, process re-bills, and work unbilled ... and update required information, insurance requirement edits, and follow-up on pending claims + You will attach i-bills or implants invoices to paper billing… more
    HCA Healthcare (11/07/25)
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  • Investigation Specialist II

    MyFlorida (West Palm Beach, FL)
    …Refugee Assistance programs, and have expertise in the use of the Florida computer system and other on-line systems . The person occupying this position works to ... - 60025069 Date: Jan 16, 2026 The State Personnel System is an E-Verify employer. For more information click...THE FOLLOWING: + Experience working with State Attorney overpayment claims + Experience with problem-solving techniques within a work… more
    MyFlorida (01/17/26)
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  • Field Service Power Generation Technician

    Cummins Inc. (Tampa, FL)
    …and tools. - Completing required documentation, such as service worksheets, timesheets, warranty claims via handwritten forms or business system input screens. - ... claims , quality documents via handwritten forms or business system input screens. Completes training in line with skill...has been resolved; documents results of troubleshooting in business systems to communicate what has been done for payment… more
    Cummins Inc. (11/18/25)
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  • Reimbursement Technical Analyst

    Cognizant (Tallahassee, FL)
    …closely with configuration analysts and other operational stakeholders to maintain and improve claims reimbursement systems . **In this role, you will:** + Review ... standards (CPT, CCI, CMS). + Manage and update the Claims Reimbursement database to ensure edit rules and tables...with CPT, CCI, CMS, or health plan-specific rules for claim payment. + Knowledge of health plan/provider contracting and… more
    Cognizant (01/08/26)
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  • Senior Product Manager

    Humana (Tallahassee, FL)
    …outcomes. **Key Responsibilities:** + Lead large-scale product efforts focused on improving claims processing and related systems , ensuring these efforts support ... with provider networks and external partners impacted by changes in claims adjudication systems **Use your skills to make an impact** **Required Qualifications**… more
    Humana (01/13/26)
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  • Medical Collector (H)

    University of Miami (Medley, FL)
    …workers' compensation (WC), bankruptcy-related cases, probate accounts requiring Statements of Claim , and billing dispute accounts. + Process subpoenas and 766 ... via outbound calls, inbound calls, and email to resolve account and claim issues. + Negotiate settlements in accordance with organizational policy. + Monitor… more
    University of Miami (01/17/26)
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  • Senior Fire Investigator, Iaai-CFI

    EFI Global (Miami, FL)
    …manner; documents all relevant facts pertaining to files in the appropriate claims handling system (s) and keeps management informed of developments that ... buildings or residences.** **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** **Investigates assigned claims suspected of insurance fraud, this includes large loss, large… more
    EFI Global (11/25/25)
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