- Publix (Lakeland, FL)
- …in Microsoft Word, Excel and PowerPoint + basic skill level in Risk Management Claims System and Medicare Reporting System **Zip Code:** 33811-3311 ... Casualty events regardless of whether they escalate to a claim . Customer claims cost $2,200 to resolve...them; proactively anticipate potential problems and implement or modify systems to prevent their occurrence + the ability to… more
- Molina Healthcare (Orlando, FL)
- …Provides support for resolution of provider claims issues, including claims paid incorrectly; analyzes systems and collaborates with respective operational ... with the member enrollment, provider information management, benefits configuration and claims processing teams to appropriately address provider claim issues.… more
- MetLife (Tampa, FL)
- …made by team member(s) within authority limit including Financial accuracy of coding Claims System including accurate claim Benefit Amount/Salary and ... calls, clear communication, accuracy of decisions and financial accuracy * Drives Claim Management Accuracy and Customer Centricity through support of the Pre-QA… more
- Percepta (Melbourne, FL)
- **Description** **_Automotive Claims Representative_** At Percepta, we bring first-class service across each market we support. As a **_Automotive Claims ... unique culture. **What You'll Be Doing** * Ability to analyze repair shop claim information to determine contract coverage * Ability to speak confidently about… more
- Molina Healthcare (Jacksonville, FL)
- …, provider and investigation/research experience. Outcome focused and knowledge of multiple systems . 1+ years of claims research and/or issue resolution or ... **Job Summary** Respond to inbound calls to provides support for provider claims adjudication activities including responding to providers to address claim … more
- CHS (Clearwater, FL)
- **Overview** ** Claims Manager** **Servicing** **Health Insurance Policies or Benefits** **Summary:** Premier Administrative Solutions (PAS) is a Third-Party ... organizations, insurance marketing organizations, and employers. One core service, claims administration, is where submissions for payment/reimbursement/sharing from medical… more
- USAA (Tampa, FL)
- …operational areas. Sets operational goals and measures to achieve overall claims targets. Designs and implements claim 's strategies supporting enterprise ... special and impactful. **The Opportunity** Accountable for auto, property and/or other claims teams to deliver operational business results at scale. Responsible for… more
- CHS (Clearwater, FL)
- **Overview** **Health Insurance Medical Claims Examiner** **Monday-Friday Schedule with daytime hours** **Responsibilities** **Summary:** The Medical Claims ... guidelines. **Essential Duties and Responsibilities:** + Reviews and adjudicates medical claims based on health policy provisions and established guidelines +… more
- Elevance Health (Tampa, FL)
- … Claims Train data, CAST Train data; CAST Lights On mgmt., E2E claim lifecycle Vetting; FICR; MGCT# Post adjudication; CPEC- Claims Payment Extract and ... **Business Architect Sr. - Government Claims ** **Location:** This role requires associates to be...Care and other provider-based root-cause investigations leveraging intimate provider system and business process knowledge to audit system… more
- Humana (Tallahassee, FL)
- …part of our caring community and help us put health first** The Bilingual Claims Research & Resolution Representative 2 manages claims operations that involve ... customer contact, investigation, and resolution of claims or claims -related financial issues. The position...skills with the ability to work across multiple software systems + Self-reliance with the ability to resolve issues… more