- 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 ... home-care and community based services. The **Clinical Document Improvement Director ** is responsible for leading encounter processing, diagnostic documentation and… more
- Carnival Cruise Line (Miami, FL)
- …cannot. The Love Boat promises something for everyone. We are looking for an amazing Director , Guest Claims Management to fill this role, which is based in our ... Here is a summary of what Princess is looking for in its Director , Guest Claims Management Is this you? **Responsibilities** + Manages the guest claims … more
- Humana (Tallahassee, FL)
- …The Medical Director relies on medical background and reviews health claims . The Medical Director work assignments involve moderately complex to complex ... or data requires an in-depth evaluation of variable factors. The Medical Director actively uses their medical background, experience, and judgement to make… more
- Humana (Tallahassee, FL)
- …The Medical Director relies on medical background and reviews health claims . The Medical Director work assignments involve moderately complex to complex ... requires an in-depth evaluation of variable factors. **Description** The Medical Director actively uses their medical background, experience, and judgement to make… more
- Humana (Tallahassee, FL)
- …The Medical Director relies on medical background and reviews health claims . The Medical Director work assignments involve moderately complex to complex ... or data requires an in-depth evaluation of variable factors. The Medical Director provides medical interpretation and decisions about the appropriateness of services… more
- USAA (Tampa, FL)
- …. Relocation assistance **is** available for this position. **Architect the Future of Claims with Scalable AI and Advanced Analytics-In Service of Those Who Serve** ... & Casualty is seeking a strategic and technically skilled Director of Data Science to lead innovation for the... of Data Science to lead innovation for the Claims organization. This high-impact role goes beyond analytics-your work… more
- Molina Healthcare (Jacksonville, FL)
- …Provider disputes and appeals to ensure adherence with Molina claims processing standards and provider contractual agreements. Includes responsibility from ... processed in accordance with local Health Plan requirements * Works with Claims , Configuration, Contracting, Provider Data Management, and other business partners to… more
- USAA (Tampa, FL)
- …apart: + P&C Claims Operations and/or Optimization experience. + 2+ years Director , Claims Operations experience. + Demonstrated P&C Claims technical ... acumen. + Deep operational knowledge of end-to-end claims processes. + Ability to drive results through others across a matrixed environment or cross-functional… more
- AdventHealth (Altamonte Springs, FL)
- …to obtain/confirm diagnosis, work restrictions and treatment plans and reports to Clinical Director any claims that need immediate FCM. + Develop a comprehensive ... in formal roundtable discussions on claim progress with clinical director and claims adjuster and legal representative (if applicable) to draft action… more
- Sedgwick (Tallahassee, FL)
- …visit for the claim. + Maintains communication with the customer, Client Service Director , and Claims Examiner providing timely updates on changes in injured ... guidelines. + Maintains ongoing communication with the client, Client Service Director , and Claims Examiner until the assigned Field Case Manager arrives onsite.… more