- CVS Health (Tallahassee, FL)
- …that may compromise the integrity of the organization's operations and claims processes. **Core Responsibilities** + **Investigative Leadership** : Conducts thorough ... billing and coding practices, verifying document authenticity, and identifying false claims or improper billing. + **Data-Driven Analysis** : Utilizes advanced data… more
- Sedgwick (Miami, FL)
- …& Insurance Adjuster General National **PRIMARY PURPOSE** **:** To handle losses or claims nationally regardless of size, including having the ability to address any ... Account. **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Examines insurance policies, claims , and other records to determine insurance coverage. + Administers… more
- Travelers Insurance Company (Tampa, FL)
- …**What Is the Opportunity?** Under moderate supervision, manage Workers' Compensation Claims with: Stable Lifetime Indemnity and/or Medical Benefits where the ... consideration. **What Will You Do?** + Manage and resolve stable lifetime claims . + May use structured settlement/annuity as appropriate for the jurisdiction. +… more
- The Falcon Group (Miami, FL)
- …personally and professionally. The Role Immediate Opening for a Forensic Engineer/ Structural Professional Engineer to work in our Miami, FL location in charge of ... preparation and expert testimony (in deposition and trial) specifically for construction defect claims , construction damage claims , and insurance claims and… more
- MyFlorida (Tallahassee, FL)
- …CITY: TALLAHASSEE COUNTY: LEON SPECIAL NOTES: Preferences: + Two (2) years of professional experience involving workers' compensation claims . + Six (6) months' ... workers' compensation specialists with reviewing and evaluating medical-only workers' compensation claims , processing and paying medical and legal bills… more
- Sedgwick (Tallahassee, FL)
- …& Insurance Adjuster Regional Marine **PRIMARY PURPOSE** **:** To handle losses or claims regionally unassisted up to $10M, including having the ability to address ... to determine insurance coverage. + Administers and reconciles complex catastrophic claims for property. + Interviews, telephones, or corresponds with claimant and… more
- MyFlorida (Tallahassee, FL)
- …TALLAHASSEE COUNTY: LEON SPECIAL NOTES: Preferences: * Two (2) years of professional experience involving workers' compensation claims . A post-secondary degree ... workers' compensation specialist with reviewing and evaluating medical-only workers' compensation claims , processing and paying medical and legal bills… more
- City of Jacksonville (Jacksonville, FL)
- …law. + Seven (7) years of progressively responsible experience in litigation. + Professional legal experience in government is preferred. + Admissions and ... applies legal principles and precedents in resolving complex legal issues. + Investigates claims and complaints by or against the Consolidated Government and… more
- Highmark Health (Tallahassee, FL)
- …SUMMARY** This job requires the ability to identify issues related to professional and facility provider claims data including determining appropriateness of ... of effective Payment Integrity strategies on a pre-payment and retrospective claims review basis. Review process includes a review of medical documentation,… more
- Carnival Cruise Line (Miami, FL)
- …to the attention of risk management and the case management (MD), clinical governance, legal , and HR teams. + Review crew claims for relevance and ... regional centers of excellence. + Coordinate and communicate with medical providers, legal , HR, and case management teams to ensure appropriate, timely care… more