• External Audit Facilitator

    Elevance Health (Tampa, FL)
    **External Audit Facilitator** **Location:** This role requires associates to be in-office 1-2 days per week, fostering collaboration and connectivity, while ... a dynamic and adaptable workplace. Alternate locations may be considered. The **External Audit Facilitator** is responsible for managing the process for claims more
    Elevance Health (05/23/25)
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  • Claims Manager

    CHS (Clearwater, FL)
    **Overview** ** Claims Manager** **Servicing** ** Health Insurance Policies or Benefits** **Summary:** Premier Administrative Solutions (PAS) is a Third-Party ... Examiner queues waiting to be adjudicated, and in either audit or needing approval status. * Developing and implementing...results will be compared to goals in each period. ** Claims Manager** ** Health Insurance Policies or Benefits**… more
    CHS (05/09/25)
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  • Business Audit - Senior Analyst (Illinois…

    CVS Health (Tallahassee, FL)
    …travel on the company's site in a cost effective manner - Knowledge of CVS Health (or other PBM) claims processing - Knowledge of retail pharmacy operations ... At CVS Health , we're building a world of health ...you will be an essential part to the Pharmacy Audit Department at CVS/Caremark. In this role, you will be… more
    CVS Health (05/16/25)
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  • Claims and Call Auditor (Call Center QC)

    CHS (Clearwater, FL)
    **Overview** ** ** ** Claims and Call Auditor (Call Center QC) - Clearwater, FL** ** ** **Summary** The Claims & Call Auditor audits processed medical insurance ... and compliance with appropriate policies, procedures, and regulations + ** Health , Dental, Vision, and Life Insurance as well as...medical audits, target audits, re-audits, etc and audits for claims which are in excess of payment authority limits… more
    CHS (05/10/25)
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  • Pharmacy Claims Auditor CPhT

    Conduent (Orlando, FL)
    … Auditor CPhT** **Do you have a CPhT certification?** **Would you like to audit pharmacy claims for accuracy?** **About the Role** Conduent Payment Integrity ... behalf of our healthcare payer clients. As a Pharmacy Claims Auditor CPhT, you will examine a wide variety...and pharmacy practices. + Responding to pharmacy calls regarding audit results and dealing with clients periodically to report… more
    Conduent (04/22/25)
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  • Manager, Claims Operations & Research

    Molina Healthcare (Miami, FL)
    **JOB DESCRIPTION** **Job Summary** Responsible for administering claims payments, maintaining claim records, and providing counsel to claimants regarding coverage ... amount and benefit interpretation. Monitors and controls backlog and workflow of claims \. Oversees analysis of complex claim inquiries and reimbursement issues using… more
    Molina Healthcare (06/07/25)
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  • Senior Commercial Auto Liability Claims

    CRC Insurance Services, Inc. (FL)
    …(United States of America) **Please review the following job description:** Process claims , which includes evaluating policy for coverage; working with the insured, ... adjusters, agents and attorneys on the claim and coordinating the payment of claims . In addition, prepare reports such as loss runs and monthly bordereau.… more
    CRC Insurance Services, Inc. (05/16/25)
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  • Commercial Auto Liability Claims Adjuster

    CRC Insurance Services, Inc. (FL)
    …(United States of America) **Please review the following job description:** Process claims , which includes evaluating policy for coverage; working with the insured, ... adjusters, agents and attorneys on the claim and coordinating the payment of claims . In addition, prepare reports such as loss runs and monthly bordereau.… more
    CRC Insurance Services, Inc. (05/16/25)
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  • Claims Sr. Quality & Training Specialist…

    Trustmark (Tallahassee, FL)
    …communities. **About the role** This role is a dedicated training position for Claims that resides in the Knowledge Management & Customer Experience group. The ... primary function of this role is to train and audit new and existing staff in all products including...claim handling process and procedures and experience in handling claims appropriately in accordance with the corporate claim philosophy,… more
    Trustmark (06/04/25)
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  • Night Audit

    Sherman Associates, Inc. (St. Pete Beach, FL)
    …hotel located in St. Pete Beach, FL, is seeking an experienced Night Audit . With stunning views overlooking the Intercoastal Waterway and Gulf of Mexico, the ... We are currently seeking a part-time and full-time night audit to join our team! Essential Functions + Registers...all Retail transactions for the guest + Issues luggage claims and check guest luggage when requested + Manages… more
    Sherman Associates, Inc. (03/29/25)
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