- IQVIA (Miami, FL)
- **Patient Support Medical Claims Processing Representative** _Contract Remote Role - Location (Open to Remote US)_ As the only global provider of commercial ... a 100% remote (work from home-WFH) contact **Patient Support Medical Claims Processing Representative** to join our...claims from HCPs or patients and vetting the claim against program specific business rules to determine if… more
- Cognizant (Tallahassee, FL)
- …Monday to Friday 8am - 4:30pm ET **Experience:** A minimum of 2 years of claim processing is required. **Travel:** None required **About the role:** As Claims ... be responsible for timely and accurate adjudication of professional and hospital claims utilizing payer specific policies and procedures. Provide support to … more
- Sedgwick (Tallahassee, FL)
- …suggested by the claim status; and provides written resumes on specific claims as requested by client. + Maintains frequent diaries on complex or high exposure ... Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Team Lead, General Liability **PRIMARY PURPOSE** : To...PURPOSE** : To supervise a team of General Liability Claim Specialists and administrative or technical staff for a… more
- Elevance Health (Miami, FL)
- …is responsible for pre and post payment and adjudication audits of high dollar claims for limited lines of business, claim types and products including ... dollar claims while maintaining acceptable levels of claims inventory and age. + Ensures claim ... including eligibility, system coding and pricing, pre-authorization, and medical necessity. + Contacts others to obtain any necessary… more
- Sedgwick (Tallahassee, FL)
- …properly documented and claims coding is correct. + May process complex lifetime medical and/or defined period medical claims which include state and ... claim or client contract. + Manages subrogation of claims and negotiates settlements. + Communicates claim ...opportunities. + A diverse and comprehensive benefits offering including medical , dental vision, 401K on day one. Sedgwick is… more
- TEKsystems (Deerfield Beach, FL)
- Job Title: Mechanical Claims Specialist Location: Remote (with initial onsite training in Deerfield Beach, FL) Start Date: August 18th Employment Type: Full-Time ... to a more comfortable, office-based role? We're seeking Mechanical Claims Specialists to join a growing customer contact team...and vehicle owners via phone and email to resolve claim -related inquiries. + Explain claim decisions clearly… more
- Molina Healthcare (Orlando, FL)
- …. + Manages a caseload of various types of complex claims . Procures all medical records and statements that support the claim . + Meets department quality and ... **JOB DESCRIPTION** **Job Summary** Responsible for administering claims payments, maintaining claim records. Monitors and controls backlog and workflow of … more
- Sedgwick (Tallahassee, FL)
- …as suggested by the claim status; and provides written resumes of specific claims as requested by client. + Assures that direct reports are properly licensed in ... Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Team Lead, Liability **PRIMARY PURPOSE** : To supervise the operation of… more
- Sedgwick (Tallahassee, FL)
- … by investigating and gathering information to determine the exposure on the claim ; manages claims through well-developed action plans to an appropriate and ... Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Examiner - Liability (REMOTE - PIP/NO FAULT exp;...; manages reserve adequacy throughout the life of the claim . + Calculates and pays benefits due; approves and… more
- CRC Insurance Services, Inc. (FL)
- …of America) **Please review the following job description:** A Complex Claims Manager - Construction Defect and Environmental is responsible for investigating, ... evaluating, and resolving insurance claims related to environmental damage, as well as ...precedents, and environmental regulations. + Calculate and assign appropriate claim reserves based on the potential damages and liability… more