- Sedgwick (Tallahassee, FL)
- …Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Auto Claims Representative, Liability **PRIMARY PURPOSE** : To analyze and process low to ... mid-level auto and transportation claims . **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Processes auto property...+ Processes auto property damage and lower level injury claims ; assesses damage, makes payments, and ensures claim files… more
- Cognizant (Tallahassee, FL)
- …and able to multi-task successfully? If so, please apply today! The Claims Processor, you will ensure accurate and timely adjudication of professional and ... hospital claims utilizing payer specific policies and procedures. Provide support to claims and client issues related to claims adjudication and adjustments.… more
- Prime Therapeutics (Tallahassee, FL)
- …our passion and drives every decision we make. **Job Posting Title** Lead Claims Processor, Government Programs **Job Description** Adjudicate or submit claims ... cause analysis and provide additional training as needed. Resolve claims edits and suspended claims . **Responsibilities** + Adjudicate or submit claims and… more
- CHS (Clearwater, FL)
- **Overview** ** ** ** Claims and Call Auditor (Call Center QC) - Clearwater, FL** ** ** **Summary** The Claims & Call Auditor audits processed medical insurance ... guidelines, performs random medical audits, target audits, re-audits, etc and audits for claims which are in excess of payment authority limits in assigned audit… more
- Elevance Health (Miami, FL)
- ** Claims Auditor I** **Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing ... an accommodation is granted as required by law._ The ** Claims Auditor** **I** is responsible for pre and post...and post payment and adjudication audits of high dollar claims for limited lines of business, claim types and… more
- Molina Healthcare (Miami, FL)
- **JOB DESCRIPTION** **Job Summary** Responsible for administering claims payments, maintaining claim records. Monitors and controls backlog and workflow of claims ... cost control standards. **KNOWLEDGE/SKILLS/ABILITIES** + Evaluates the adjudication of claims using standard principles and state specific policies and regulations… more
- Insight Global (St. Petersburg, FL)
- Job Description Insight Global is seeking a detail-oriented and dependable Claims Processor to join our team in Clearwater, FL. This position plays a key ... administrative role in supporting the claims department through accurate data entry, document management, and...teams. The ideal candidate will have prior experience in claims processing and a strong commitment to accuracy and… more
- Molina Healthcare (Orlando, FL)
- …clear and concise to ensure accuracy in auditing of critical information on claims ensuring adherence to business and system requirements of customers as it pertains ... days of error issuance. * Evaluates the adjudication of claims using standard principles and state specific policies and...fraudulent billing practices, waste, overpayments, and processing errors of claims . ( _Use for claims specific positions… more
- Elevance Health (Tampa, FL)
- **Clinical Documentation and Claims Integrity Director** **Location:** Alternate locations may be considered. This position will work a hybrid model (remote and ... is responsible for leading encounter processing, diagnostic documentation and claims integrity across CareBridge. The ideal candidate has experience working… 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