- Travelers Insurance Company (Fort Lauderdale, FL)
- …information to uncover potentially fraudulent activity. The investigator, supporting a Claim Center, will investigate claims deemed suspicious in nature ... of a claim . Periodically engages in specialized investigative area, including Medical , Cyber, Cargo, Fire Motive & Opportunity, etc. + Analyzes, monitors and… more
- Sedgwick (Orlando, FL)
- …MN 55344 **PRIMARY PURPOSE** : Provides disability case management and complex claim determinations based on medical documentation and the applicable disability ... and making timely payments/approvals and adjustments, medically managing disability claims including comorbidities, concurrent plans, and complex ADA accommodations;… more
- USAA (Miami, FL)
- …accurately manages claims outcomes. + Maintains accurate, thorough, and current claim file documentation throughout the claims process. + Advance knowledge ... and framework to investigate, evaluate, negotiate, and settle complex property insurance claims presented by or against our members. You will confirm and analyzes… more
- Butterfly Effects (Deerfield Beach, FL)
- …You Be Doing? + Accurately input patient demographics, authorizations, CPT codes, and claim details before submission. + Process claims using the First-In / ... makes a difference! Butterfly Effects is looking for a Medical Billing Specialist to support our national billing needs....deadlines. + Identify and resolve billing errors to reduce claim denials. + Correct and resubmit denied claims… more
- GE Aerospace (Jacksonville, FL)
- …eligibility requirements, and limitations + Strong preference for long term care insurance claim experience + Working knowledge of medical terminology and ... In this high-impact role, you'll deliver sharp insights, adjudicate complex claims , and collaborate across teams using advanced analytics and emerging technology.… more
- Northwest Florida Community Hospital (Chipley, FL)
- …(NFCH), in Chipley, FL, is seeking a FT experienced, energetic and dedicated Medical Business Office Manager to provide exceptional care for our patients in support ... with medical Providers and staff, in our Patient Financial Services...up-to-date knowledge related to CMS guidelines, ICD-10 requirements, UB/1500 claim submission data and elements required for clean … more
- Highmark Health (Tallahassee, FL)
- …and retrospective claims review basis. Review process includes a review of medical documentation, itemized bills, and claims data to assure appropriate level ... the ability to identify issues related to professional and facility provider claims data including determining appropriateness of code submission, analysis of the … more
- Zelis (FL)
- …based clinical criteria plan, and policy exclusions. Conduct reviews on inpatient DRG claims as they compare with medical records ICD-10 Official Coding ... evidence supplied by the provider in the form of medical records such as physician notes, lab tests, images...concepts to expand the DRG product. + Manage assigned claims and claim report, adhering to client… more
- Sedgwick (Orlando, FL)
- …naturally empathic and solution-focused. **ESSENTIAL RESPONSIBLITIES MAY INCLUDE** + Makes claim determinations to approve non-complex disability claims or makes ... your 2+ years' experience in a office setting or medical experience and grow with us! + A stable...professional needs. **PRIMARY PURPOSE OF THE ROLE:** To process claims and determine benefits due pursuant to a disability… more
- Sedgwick (Orlando, FL)
- …time frames, and claims status either by phone, written correspondence and/or claims system. + Reviews medical information to determine if the claimant meets ... and/or client requirements for a qualifying condition. + Makes claim determinations to approve non-complex ADA claims ...benefits package is offered including but not limited to, medical , dental, vision, 401k and matching, PTO, disability and… more