- CDM Smith (Sarasota, FL)
- …and construction managers on projects. Coordinates and controls all construction management activities, including critical path method (CPM), scheduling and ... claims administration. Interprets plans and specifications for clients, contractors,...Performs other duties as required. **Job Title:** CEI Construction Management Professional 7 **Group:** CEI **Employment Type:** Regular **Minimum… more
- CDM Smith (Boca Raton, FL)
- …**Business Unit:** TSU **Job Description:** Plans, manages, and oversees construction management activities on small to medium size construction projects of routine ... assigned activities including critical path method (CPM), scheduling and claims administration. Interprets plans and specifications for clients, contractors, and… more
- Kemper (Doral, FL)
- …SIU Investigator will conduct field as well as desk investigations of insurance claims referred to and accepted for investigation by the Special Investigative Unit. ... the Downers Grove and surrounding areas. Basic functions include: Investigation of claims , analysis and development of facts and evidence, and conducting and/or… more
- Molina Healthcare (Miami, FL)
- …Clinical Coder (CCC), Certified Medical Audit Specialist (CMAS), Certified Case Manager (CCM), Certified Professional Healthcare Management (CPHM), Certified ... DUTIES:** + Facilitates clinical/medical reviews of retrospective medical claim reviews, medical claims and previously denied cases in which an appeal has been made,… more
- Public Consulting Group (Tallahassee, FL)
- …through claim issue research. Additional this position will assist in performing claims processing, medical record audits for all implemented agencies, and assist ... and medical record reviews that will include discussion with internal management to ensure understanding of results. **Summary of Functions** The Contract… more
- The Hartford (Lake Mary, FL)
- …goals, you are encouraged to apply. If uncertain, consider discussing it with your manager . The Claims Liability Performance Analytics team is seeking a Senior ... to identify and drive meaningful improvement within the Auto Bodily Injury Claims organization, focusing on severity management , litigation strategies, and… more
- Elevance Health (Lake Mary, FL)
- …healthcare fraud in order to recover corporate and client funds paid on fraudulent claims . **How you will make an impact:** + Claim reviews for appropriate coding, ... and claim systems for review of facility, professional and pharmacy claims . + Responsible for independently identifying and developing enterprise-wide specific… more
- Sedgwick (Orlando, FL)
- …from some of the world's most respected brands + A **dedicated mentor and manager ** to guide you every step of your career journey + **Career development and ... on client plans, state and federal regulations. Ensures that on-going claim management is within company service standards and industry best practices. **ESSENTIAL… more
- Elevance Health (Tampa, FL)
- …is responsible for auditing inpatient medical records and generating high quality recoverable claims for the benefit of the company, for all lines of business, and ... duties may include, but are not limited to:** + Analyzes and audits claims by integrating medical chart coding principles, clinical guidelines and objectivity in the… more
- Otsuka America Pharmaceutical Inc. (Tallahassee, FL)
- …plan. This position provides guidance, coaching, and oversight to the Manager , Medical Core Content, ensuring all materials are developed with scientific ... Direction** + Provide guidance, coaching, and oversight over the work of the Manager , Medical Core Content, managing and ensuring the development of core scientific… more