- Sedgwick (Miami, FL)
- …- Hybrid **PRIMARY PURPOSE** : To analyze complex or technically difficult general liability claims to determine benefits due; to work with high exposure claims ... involving litigation and rehabilitation; to ensure ongoing adjudication of claims within service expectations, industry best practices and specific client service… more
- Travelers Insurance Company (Orlando, FL)
- …negotiating and resolving assigned Construction Defect and latent Property Damage claims . Provides quality claim handling throughout the claim life cycle (customer ... our business partners. **What Will You Do?** + Directly handles assigned severity claims . + Provides quality customer service and ensures quality and timely coverage… more
- CVS Health (Tallahassee, FL)
- …**Position Summary** This position will be responsible for utilizing previous ACAS claims experience along with provided guidance to review and validate claims ... candidate will be able to work independently and with others to review claims tied to different overpayment projects in the Overpayment Tracking System, revalidate… more
- AdventHealth (Altamonte Springs, FL)
- …clean claims rate + Performs peer-to-peer discussions with payer Medical Directors and/or discusses cases with payer representatives to facilitate claim ... as a liaison between UM and CM teams and medical staff, as well as, the medical ...Advisor is responsible for providing clinical review of utilization, claims management, and quality assurance related to inpatient care,… more
- Otsuka America Pharmaceutical Inc. (Tallahassee, FL)
- …medicines for those with CNS disorders, we are seeking a skilled and experienced Medical Director of CNS Early Assets, Global Medical Affairs, responsible for ... certain assets within the broader CNS TA portfolio Medical Affairs (both US and Global), with a specialization...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more
- Otsuka America Pharmaceutical Inc. (Tallahassee, FL)
- **Position Summary:** The Associate Director of Global Medical Affairs Omnichannel will be responsible for developing and leading the omnichannel strategy for Global ... Medical Affairs across all therapeutic areas and brands. This...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more
- Otsuka America Pharmaceutical Inc. (Tallahassee, FL)
- **Position Summary** : Reporting to the Vice President, Global Medical Affairs, the Executive Director, CNS Strategy, Global Medical Affairs is a leadership ... position responsible for the strategic and tactical medical plans of both global and US ...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more
- USAA (Port Saint Lucie, FL)
- …responsible for the investigation, negotiation, evaluation and appraisal of vehicle damage claims for both repairable and total loss vehicles to ensure estimate ... use of digital tools, evaluate and appraise highly complex auto physical damage claims in accordance with the terms and conditions of the contract, corporate… more
- NextEra Energy (North Palm Beach, FL)
- …provides coverage to both affiliated and non-affiliated risks. As the Operations Analyst for Claims & Finance, you will be assisting the Claims and Finance team ... Notice of Loss), following up with TPAs (Third Party Administrators), manage claims BDXs (Bordereau), processing invoices, generate loss runs & reports, documenting… more
- Elevance Health (Tampa, FL)
- …and dollar volume of provider. + Schedules review with provider, analyzes data to select claims to be reviewed, conducts review using medical charts, medical ... Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical -expense spending. The **Provider Auditor** conducts on-site reviews of … more