- DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
- Position Purpose: The Claims Examiner is responsible for providing expertise and/or claims support in reviewing, researching, investigating, processing and ... adjusting claims and other duties as necessary. Key Responsibilities: +...as established for the position in the area of quality and production Qualifications: + High School Diploma or… more
- USAA (Tampa, FL)
- …candidate selected for this position will be joining the Service Team within the Claims Actuary and Analytic community, which is part of P&C Data Science. They be ... responsible for delivering insights to the Claims organization related to all things Service to better...technical audiences. + Identifies and captures the relevant and quality data sources required to fully answer and address… more
- Molina Healthcare (Jacksonville, FL)
- **JOB DESCRIPTION** **Job Summary** Responsible for administering claims payments, maintaining claim records, and providing counsel to claimants regarding coverage ... benefit interpretation. Monitors and controls backlog and workflow of claims . Ensures that claims are settled in...manner to ensure compliance to departmental turn-around time and quality standards. + Meets department quality and… more
- USAA (Tampa, FL)
- …impactful. **The Opportunity** We are seeking a dedicated Business Process Owner Lead - Claims User Experience - Claims Optimization. We offer a flexible work ... consulting, and/or process engineering/optimization. + Experience in successfully applying quality management, process improvement, and problem-solving tools and methodologies.… more
- LogixHealth (Dania, FL)
- Location: On-Site in Dania, FL This Role: As a Claims Specialist, you will work with internal teams to provide cutting-edge solutions that will directly improve the ... and carry out processes on all out of network claims . The ideal candidate will have strong technological skills,...clinical, and other data insights that directly improve the quality and efficiency of patient care. At LogixHealth, we're… more
- AssistRx (Orlando, FL)
- …and external business review meetings. Responsible for forecasts and analyzing claims data to determine Copay utilization, establish escrow account minimum balances ... well as make recommendations to increase utilization based on Copay claims and patient compliance/adherence activities. Also, this position will implement… more
- Humana (Tallahassee, FL)
- …your opportunity to lead cross-functional initiatives, apply your expertise in healthcare claims , and shape the future of operational excellence in a dynamic, ... analyzing, and implementing strategies to improve operational efficiency, service quality , and overall performance across the enterprise shared service functions… more
- Publix (Lakeland, FL)
- **33789BR** **Position Title:** PROFIT Plan Claims Processing Specialist, Retirement - Lakeland **Department:** Benefits Administration **Location:** Lakeland, FL ... Matter Expert (SME) for the Retirement business area, + Processing beneficiary claims for PROFIT Plan distributions, + Providing premier customer service to lobby… more
- Lincoln Financial (Tallahassee, FL)
- …Security application process. You will work together with several partners, such as Claims and Vendors, to successfully apply for and secure SSDI benefits. If you ... and take appropriate action to meet or exceed standards. + Complete regular quality audits of assigned area(s) of responsibility; record results and coach staff to… more
- USAA (Tampa, FL)
- …and/or process engineering/optimization. + Experience in successfully applying quality management, process improvement, and problem-solving tools and methodologies. ... systems to collect and analyze data. **What sets you apart:** + P&C Property Claims Operations and/or Optimization experience + Over 2 years MCO experience + Deep… more