- Zelis (St. Petersburg, FL)
- …members achieve more favorable financial outcomes. What you will do: + Analyze medical claims submitted by members along with their Explanation of Benefits ... claim processing and provider billing issues. Additionally, the Medical Bill Navigator also supports efforts to negotiate reduced...to Zelis: + Bachelor's Degree + 5+ years of medical claims & member benefit application experience… more
- The Hartford (Lake Mary, FL)
- …theirs, too. Join our team as we help shape the future. The Claims Team Leader will manage and direct claim investigation, compensability determination, ... and execution of the investigation, disposition and settlement of claims , in compliance with corporate claim standards...partner with internal and external customers + Knowledge of medical terms is strongly preferred + Possess analytical and… more
- Travelers Insurance Company (Tampa, FL)
- …issue accurate and timely indemnity, medical and expense payments for lifetime/long-term claims . + Determine Value of Claim . + Complete required letters and ... 1 **What Is the Opportunity?** Under moderate supervision, manage Workers' Compensation Claims with: Stable Lifetime Indemnity and/or Medical Benefits where the… more
- Sedgwick (Miami, FL)
- …properly documented and claims coding is correct. + May process complex lifetime medical and/or defined period medical claims which include state and ... pursuant to the claim or client contract. + Manages subrogation of claims and negotiates settlements. + Communicates claim action with claimant and client.… more
- USAA (Tampa, FL)
- … claim damages including communicating with the insured, internal claims adjusters, and third parties/vendors. May require face-to-face interactions with members ... Special Investigations Unit for handling, if applicable. + Maintain accurate and current claim file documentation throughout the claims process for complex … more
- Allied Universal (Jacksonville, FL)
- Company Overview: Advance Your Career in Insurance Claims with Allied Universal(R) Compliance and Investigation Services. Allied Universal(R) Compliance and ... Investigation Services is the premier destination for a career in insurance claim investigation. As a global leader, we provide dynamic opportunities for claim … more
- Travelers Insurance Company (Tallahassee, FL)
- …Openings** 1 **What Is the Opportunity?** Lead the strategy and operations of Travelers Claim Medical initiatives focusing on how developments in the broader ... externally. + This position will oversee the following key areas: + Medical Claim Product Research, Strategy and Innovation: + Design and direct innovative,… more
- Sedgwick (Tallahassee, FL)
- …to support the claim request and documents decision rationale. + Completes medical review of all claims by reviewing medical documentation received ... medical management of claims including comprehension of medical terminology and substantiating claim decisions. **ADDITIONAL FUNCTIONS and… more
- Sedgwick (Orlando, FL)
- …to callers regarding claims for multiple lines of business; to expedite the claims application process and provide detailed claim notes on all calls; to ... Inbound call center experience preferred. **Skills & Knowledge** + Knowledge of medical terminology + Understanding of claims management + Excellent oral… more
- Sedgwick (Orlando, FL)
- …establish expectations for return-to-work timelines and accommodations.** **Manages complex disability claims with a focus on medical compliance, duration ... system documentation.** **Coordinates investigative efforts to ensure thorough and appropriate claim reviews.** **Identifies when claims require external support… more