- USAA (Tampa, FL)
- …Ability to conduct complex healthcare fraud investigation reviews. + Knowledge of health insurance claims operations, particularly Medicare Supplement ... + Interprets relevant medical literature for application to appropriate health insurance underwriting policies and guidelines. +...advanced medical expertise by serving as primary resource for Health Claims for the approach to medical… more
- Highmark Health (Tallahassee, FL)
- …+ Bachelor's degree **EXPERIENCE** **Required** + 5 years of relevant, progressive experience in health insurance claims + 3 years of prior experience ... processing 1st dollar health insurance claims + 3 years of experience with medical terminology **Preferred:** + 3 years of experience in a Stop Loss … more
- CHS (Clearwater, FL)
- **Overview** ** Health Insurance Medical Claims Examiner** **(Initial Training On Site - 90 days - Remote position after training in FL)** **Must live within ... **Summary:** The Medical Claims Examiner adjudicates medical claims based on health policy provisions and... Examiner adjudicates medical claims based on health policy provisions and established guidelines. **Essential Duties and… more
- CHS (Clearwater, FL)
- **Overview** ** Claims Manager** **Servicing** ** Health Insurance Policies or Benefits** **Summary:** Premier Administrative Solutions (PAS) is a Third-Party ... Actual results will be compared to goals in each period. ** Claims Manager** ** Health Insurance Policies or Benefits** **Qualifications** **Qualifications and… more
- Elevance Health (Tampa, FL)
- … experience required with understanding of health insurance policies, health insurance claims handling and provider network contracting. **How will ... Payment Integrity is a proud member of the Elevance Health family of companies, Carelon Insights, formerly Payment Integrity,... claims . Health insurance… more
- AdventHealth (Maitland, FL)
- … claims analytics strongly preferred. + Managed Care, Patient Financial services, health insurance claims processing, contract management, or medical ... Repayment Program - Career Development - Whole Person Wellbeing Resources - Mental Health Resources and Support **Our promise to you:** Joining AdventHealth is about… more
- Healthfirst (FL)
- …institution. + Work experience demonstrating oral and written communication skills. + Health insurance claims processing, COB or related experience ... outbound calls to members and/or other primary insurers to validate insurance coverage, update all Healthfirst and/or secondary systems (including potentially CMS… more
- Elevance Health (Miami, FL)
- …The ** Claims Representative III** is responsible for keying, processing and/or adjusting health claims in accordance with claims policies and procedures. ... **Job Title:** Claims Representative III **Schedule:** Monday-Friday 7am-3:30pm EST **Virtual**...50,000 members, HealthSun is one of the fastest growing health plans in South Florida. As a local plan,… more
- Orlando Utilities Commission (Orlando, FL)
- …commercial insurance and policy renewals. + Oversee the budget development for insurance claims , premiums, and payroll impacts; + Review and approve all ... **_Reliable_** **One** **,** is presently seeking a **Manager of Insurance & Claims ** to join the Risk...account, defined contribution with employer matching along with a health reimbursement account + Generous paid vacation, holidays, and… more
- CRC Insurance Services, Inc. (FL)
- …Claims Manager - Environmental is responsible for investigating, evaluating, and resolving insurance claims related to environmental damage, as well as ... regulations, and compliance standards. + Proven experience in managing complex insurance claims , including investigation, evaluation, and resolution. + Ability… more