- Molina Healthcare (Miami, FL)
- **Job Description** **Job Summary** The Provider Claims Adjudicator is responsible for responding to providers regarding issues with claims , coordinating, ... investigates and confirms the appropriate resolution of claims issues. This role will require actively researching issues...line of business or state **Job Function** Provides customer support and stellar service to assist Molina providers with… more
- Molina Healthcare (Orlando, FL)
- …types of complex claims . Procures all medical records and statements that support the claim. + Meets department quality and production standards. + Meet State ... **JOB DESCRIPTION** **Job Summary** Responsible for administering claims payments, maintaining claim records. Monitors and controls...claim records. Monitors and controls backlog and workflow of claims . Ensures that claims are settled in… more
- Sedgwick (Tallahassee, FL)
- …a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Team Lead I Workers Comp (Calif Exp) **PRIMARY PURPOSE:** To supervise the ... individual claim activities; to provide technical/jurisdictional direction to examiner reports on claims adjudication; and to maintain a diary on claims in… more
- Sedgwick (Tallahassee, FL)
- …a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Team Lead, General Liability **PRIMARY PURPOSE** : To supervise a team of ... and to maintain diary in the teams on complex or high exposure claims . **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Supervises a team of GL Specialists and/or… more
- The Hartford (Lake Mary, FL)
- …that is helpful to customers Teamwork and Team Building: + Contribute and support a team environment that achieves Claims ' Diversity and Inclusion initiatives ... Specialist Claims - CH07DE We're determined to make a...manage the investigation, litigation, disposition, and settlement of specialized claims , in compliance with corporate claim standards and procedures,… more
- Sedgwick (Tallahassee, FL)
- …Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Specialist Sr , Professional Liability (MEDMAL) **PRIMARY PURPOSE** : To analyze ... complex or technically difficult medical malpractice claims ; to provide resolution of highly complex nature and/or severe injury claims ; to coordinate case… 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** +...high level of quality and professionalism. + Provide backup support to other team/group members in the performance of… more
- Molina Healthcare (Miami, FL)
- …caseload of claims . Procures all medical records and statements that support the claim. + Makes recommendations for further investigation or resolution. + ... **JOB DESCRIPTION** **Job Summary** Responsible for administering claims payments, maintaining claim records. Monitors and controls...claim records. Monitors and controls backlog and workflow of claims . Ensures that claims are settled in… 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
- USAA (Tampa, FL)
- …and implementation of multiple Data and Analytics sub-functions for Claims that may include: Information Strategy and Architecture, Information Management, ... Information Governance, Information Delivery Analytics & Insights Delivery, and Support . Lead the short-term and long-term strategy and vision of the assigned… more