- CHS (Clearwater, FL)
- **Overview** **Health Insurance Medical Claims Examiner** **Monday-Friday Schedule with daytime hours** **Responsibilities** **Summary:** The Medical ... Claims Examiner adjudicates medical claims based on health policy provisions and established guidelines....guidelines. **Essential Duties and Responsibilities:** + Reviews and adjudicates medical claims based on health policy provisions… more
- Sedgwick (Jacksonville, FL)
- …properly documented and claims coding is correct. + May process low-level lifetime medical and/or defined period medical claims which include state and ... Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Representative - Workers Compensation | Jurisdiction: Multi State | TX/FL/OK/LA… more
- Molina Healthcare (Orlando, FL)
- … function efficiency. **Required Qualifications** * At least 3 years of medical claims processing experience, or equivalent combination of relevant education ... and experience. * Medical claims processing experience across multiple states, markets, and claim types. * Knowledge of claims processing related to… more
- DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
- …duties as necessary Qualifications: + High School Diploma or GED + 3+ years as Medical Claims Examiner + Experience in contract interpretation + Knowledge of CMS ... Position Purpose: The Claims Examiner III ensures that claims are processed according to department standards and assists the Claims manager in maintaining… more
- Sedgwick (Tallahassee, FL)
- … Specialist **PRIMARY PURPOSE** **:** To analyze complex or technically difficult medical malpractice claims ; to provide resolution of highly complex nature ... and RESPONSIBILITIES** + Analyzes and processes complex or technically difficult medical malpractice claims by investigating and gathering information to… more
- Modernizing Medicine (FL)
- …previous healthcare administration or related experience required + Basic understanding of medical billing claims submission process and working with insurance ... cloud platform. Our vision is a world where the software we build increases medical practice success and improves patient outcomes. Founded in 2010 by Daniel Cane… more
- The Walt Disney Company (Celebration, FL)
- …excess carrier, Legal, and Security + Oversight of investigations, including crew medical sign off claims , liability of bodily injury, property damage, ... the boundaries of entertainment and create unforgettable guest experiences. The Manager, Claims (Disney Cruise Line) will provide strategic leadership to a team of… more
- Humana (Tallahassee, FL)
- …a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to make ... reference materials, internal teaching conferences, and other reference sources. Medical Directors will learn Medicare, Medicare Advantage, and Medicaid requirements… more
- Humana (Tallahassee, FL)
- …a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to make ... reference materials, internal teaching conferences, and other reference sources. Medical Directors will learn Medicare, Medicaid, and Medicare Advantage requirements… more
- Highmark Health (Tallahassee, FL)
- …including but not limited to, Clinical Strategy, Sales/Client Management, Customer Service, Claims , and Medical Policy. The person in this position must ... resource that coordinates, analyzes, and interprets the benefits and claims processes for clinical teams and serves as a...of the job. Assess benefit limitations in accordance with Medical Policy Guidelines. + Monitor and identify claim processing… more