- Acosta Group (Jacksonville, FL)
- …The Director will manage a team including the Sr. Risk Claims Analysts and collaborate closely with internal stakeholders, third-party administrators, brokers, ... and insurers to ensure effective claims management, litigation, risk financing, and compliance. **RESPONSIBILITIES** **Essential Functions of this Position:** +… more
- Sedgwick (Tallahassee, FL)
- …best brands? + Apply your knowledge and experience to adjudicate complex customer claims in the context of an energetic culture. + Deliver innovative customer-facing ... and inclusion. **PRIMARY PURPOSE** **:** To provide excellent service to callers regarding claims for multiple lines of business; to expedite the claims … more
- Sedgwick (Orlando, FL)
- …12650 Ingenuity Dr Orlando FL 32826 **PRIMARY PURPOSE:** To process claims and determine accommodation options following written guidelines and procedures pursuant ... absence eligibility review; and to ensure the ongoing processing of claims . **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** * Informs claimants of documentation… more
- Molina Healthcare (St. Petersburg, FL)
- …Lead Analyst, Configuration Oversight to support our Payment Integrity and Claims Operations teams in ensuring the accuracy and compliance of Coordination ... and regulatory guidance. The ideal candidate will bring deep knowledge of claims adjudication, QNXT system navigation, and strong analytical acumen. Experience in… more
- City of Jacksonville (Jacksonville, FL)
- …the monitoring, reviewing, investigating, and processing of complex workers' compensation claims that include primarily lost time, permanent total disability, and ... workers' compensation laws, rules, and regulations and workers' compensation claims processing practices and procedures with substantial litigation experience… more
- Sedgwick (Orlando, FL)
- …and making timely payments/approvals and adjustments, medically managing disability claims including comorbidities, concurrent plans, and complex ADA accommodations; ... coordinates investigative efforts, thoroughly reviews contested claims , negotiates return to work with or without job accommodations, and evaluates and arranges… more
- Molina Healthcare (Orlando, FL)
- …test approach, strategy for test automation and test analytics, enforcing test quality standards, and providing whole project support and oversight. In addition to ... + SQL expertise + Excel expertise + Medicare, Medicaid, Marketplace claims expertise **PHYSICAL DEMANDS:** Working environment is generally favorable and lighting… more
- AdventHealth (Maitland, FL)
- …modeling and risk forecasting Identify and/or implement improvements in quality control/timeliness of reporting Manage extracts, collects, analysis and ... sources using knowledge of healthcare managed care contracts and healthcare administrative claims data Reviews existing complex models and implements them on new… more
- Sedgwick (Jacksonville, FL)
- …PURPOSE** **:** To manage claim caseload of basic to highly complex claims within granted authority level including related financial implications, along with ... such as subrogation, fraud evaluation or case management review to resolve claims . + Establishes and maintains effective relationship with internal and external… more
- Suddath (Jacksonville, FL)
- …training, and maintaining equipment to be available as needed. + Coordinate with the Quality Assurance Manager and Claims Manager in the areas of training, ... **Major Goal:** To provide for on-time, safe, and high quality completion of all service commitments of the company,...end of day checks, and monitor them for completion. ** Quality and Capacity:** + Schedule jobs, crews, equipment, and… more