- The Hartford (Lake Mary, FL)
- …and successfully investigating, reserving, recommending and implementing strategies to resolve claims consistent with corporate claim standards, policies and ... execute file strategies including investigation, valuation, disposition and settlement of assigned claims , in a manner consistent with corporate claim settlement… more
- Molina Healthcare (Tampa, FL)
- …**Job Duties** + Performs clinical/ medical reviews of retrospective medical claim reviews, medical claims and previously denied cases, in which ... documentation for denial and modification of payment decisions + Independently re-evaluates medical claims and associated records by applying advanced clinical… more
- CVS Health (Tallahassee, FL)
- …non-participating providers. Additionally, they will assist in creating bulletins, newsletters, and claim trainings to improve provider claims issues. as well as ... Field Analyst** works with the grievance and appeal and claims operations department to trend provider claim ...assigned. **Required Qualifications** + 3+ years of experience in medical billing and coding, specifically related to claims… more
- Sedgwick (Tampa, FL)
- …FUNCTIONS and RESPONSIBILITIES** + Proactively and strategically manages a complex claim inventory by assessing complex claims issues, utilizing jurisdictional ... Workplaces in Financial Services & Insurance General Product and Liability Complex Claim Advisor - Multi-State Licensing Preferred - Hybrid - Sedgwick Offices **ARE… more
- Cognizant (Tallahassee, FL)
- **Healthcare Accounts Receivables - Claims Denials (remote)** Cognizant is one of the world's leading professional services companies, we help our clients modernize ... successful candidate performs advanced level work related to resolution of physician claim denials. This position will be responsible for root cause analysis… more
- CVS Health (Tallahassee, FL)
- …competently, accurately and efficiently. **Preferred Qualifications** - 18+ months of medical claim processing experience - Self-Funding experience - DG ... day. **Position Summary** Reviews and adjudicates complex, sensitive, and/or specialized claims in accordance with plan processing guidelines. Acts as a subject… more
- CVS Health (Tallahassee, FL)
- …Excel and Microsoft Word **Preferred Qualifications** -2-4 years experience as a medical assistant, office assistant or claim processor -MedCompass, CEC, or ... Summary** **Position Summary** Responsible for initial review and triage of claims tasked for review. -Determines coverage, verifies eligibility, identifies and… more
- Sedgwick (Orlando, FL)
- …to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Specialist, Sr. Medical Malpractice (Professional Liability) **PRIMARY PURPOSE** ... : To analyze complex or technically difficult medical malpractice claims ; to provide resolution of...and gathering information to determine the exposure on the claim ; manages claims through well-developed action plans… more
- Sedgwick (Tallahassee, FL)
- …Coverage Specialist **PRIMARY PURPOSE** **:** To analyze complex or technically difficult medical malpractice claims ; to provide resolution of highly complex ... and RESPONSIBILITIES** + Analyzes and processes complex or technically difficult medical malpractice claims by investigating and gathering information to… more
- The Hartford (Lake Mary, FL)
- …Unit will manage the investigation, litigation, disposition, and settlement of specialized claims , in compliance with corporate claim standards and procedures, ... and execution of the investigation, litigation, disposition, and settlement of specialized claims , in compliance with corporate claim standards and procedures,… more