- The Hartford (Lake Mary, FL)
- …with teammates in Claims Strategy and Optimization, Claims Performance Analytics, Claims Data Office, Claims Field operations and key stakeholders to ... personnel at all levels, including but not limited to Claims senior leadership, field operations , data science...not limited to Claims senior leadership, field operations , data science staff, and business segment leaders. Responsibilities:… more
- Highmark Health (Tallahassee, FL)
- …MUST BE A US CITIZEN This position serves as a key liaison between Claims Operations , Customer Service, Regulatory Affairs, IT, Legal and other departments, ... and industry regulatory changes and assess their potential impact on Claims Operations , Customer Service and other operational areas processes and collaborate… more
- Humana (Tallahassee, FL)
- …your skills to make an impact** **Required Qualifications** + 5+ years of claims operations related experience + Experience with analyzing, reconciling and ... The Senior Encounter Data Management Professional ensures data integrity for claims errors. The Senior Encounter Data Management Professional work assignments… more
- Humana (Tallahassee, FL)
- …They will work closely with IT, the pricing software vendor, CIS BSS, Medicaid operations , claims operations , and other business teams involved in the ... APR-DRG and/or EAPG grouper logic + Experience processing or reviewing facility claims + Prior professional experience utilizing Microsoft Excel (eg performing basic… more
- NextEra Energy (North Palm Beach, FL)
- …insurance subsidiary and provides coverage to both affiliated and non-affiliated risks. As the Operations Analyst for Claims & Finance, you will be assisting the ... **E&S Operations Specialist** **Date:** Jul 31, 2025 **Location(s):** North...Loss), following up with TPAs (Third Party Administrators), manage claims BDXs (Bordereau), processing invoices, generate loss runs &… more
- NextEra Energy (North Palm Beach, FL)
- …+ Identify, assess, and prioritize operational risks inherent in insurance operations , including underwriting, claims processing, operations , finance, ... identifying, assessing, monitoring, and mitigating operational risks specific to insurance operations . They will work closely with various departments to implement… more
- Kemper (Tampa, FL)
- …company and state requirements. + Works directly with strategic partners like Product, Claims , and Operations on issues impacting the account. + Performs other ... or comparable sales/marketing management experience + Extensive knowledge of insurance operations : claims , coverages, products and underwriting is preferable to… more
- CVS Health (Tallahassee, FL)
- …specifically Medicare Advantage products such as product development, clinical, claims , operations requirements, implementation, and plan sponsor structure ... implementation **Preferred Qualifications** Strong Employer Group Medicare product/benefit and operations knowledge Prophecy with Microsoft products Strong Analytical Skills… more
- Molina Healthcare (St. Petersburg, FL)
- …outcomes and benefit realization + Demonstrates deep understanding of Core Operations , Claims and Enrollment processes, deliverables, vendor partners and ... responsible for the holistic management of the external vendor relationships for Claims and Enrollment activities (along with other Core Ops areas of… more
- MetLife (Tampa, FL)
- …knowledge/working knowledge of FMLA/Disability/Leave procedures preferred Business Category Operations - Claims Equal Employment Opportunity/Disability/Veterans ... administer Family & Medical Leave Act standalone/ADA (as well as other leave) claims and adhere to federal and state regulatory and/or company plan requirements and… more