- USAA (Port Saint Lucie, FL)
- …to ensure compliance with laws, regulations, and policy provisions. + Review claims /suppliers for fraud indicators and refers to Special ... responsible for the investigation, negotiation, evaluation and appraisal of vehicle damage claims for both repairable and total loss vehicles to ensure estimate… more
- NextEra Energy (North Palm Beach, FL)
- … claims , and accounting teams + Manage reinsurance bookings + Reconcile premiums, claims , and collections + Review underwriting and claims Bordeaux + ... affiliated and non-affiliated risks. As the Operations Analyst for Claims & Finance, you will be assisting the ...and internal team to ensure files are received timely, review accuracy of the data and follow-up on action… more
- AdventHealth (Altamonte Springs, FL)
- …of Utilization Management, the Physician Advisor is responsible for providing clinical review of utilization, claims management, and quality assurance related to ... clean claims rate + Performs peer-to-peer discussions with payer Medical Directors and/or discusses cases with payer representatives to facilitate claim… more
- Molina Healthcare (Miami, FL)
- …as the professional scope of a Payment Integrity Clinician. This includes assessing medical documentation, itemized bills, and claims data to ensure appropriate ... tracking cost containment initiatives through comprehensive clinical and financial analysis of claims data, medical documentation, and itemized bills. + Leads… more
- Sedgwick (Orlando, FL)
- …eligibility review ; and to ensure the ongoing processing of claims . **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** * Informs claimants of documentation required to ... claims status either by phone, written correspondence and/or claims system. * Reviews medical information to determine if the claimant meets the requirements… 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...+ Collaborate with Compliance and Legal to maintain robust review processes and documentation. + **Leadership & Innovation:** +… more
- Otsuka America Pharmaceutical Inc. (Tallahassee, FL)
- …teams including providing oversight of integrated brand strategy and plans + Represents Global Medical Affairs on Copy Review governance committee + Is a core ... **Position Summary** : Reporting to the Vice President, Global Medical Affairs, the Executive Director, CNS Strategy, Global ...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more
- Kemper (Lake Mary, FL)
- …to our stakeholders that delivers on our promises._ **Position Summary:** Our Claims Litigation Specialist will investigate, evaluate and handle to conclusion all ... assigned litigated claims . The Litigation Specialist will have advanced claim handling...FL, and Henderson, NV **Position Responsibilities:** + Ability to review loss facts, including legal pleadings and new suits… more
- Travelers Insurance Company (Orlando, FL)
- …and resolving assigned General Liability related Bodily Injury and Property Damage claims . Provides quality claim handling throughout the claim life cycle (customer ... not manage staff. **What Will You Do?** + Directly handles assigned severe claims . + Provides quality customer service and ensures file quality and timely coverage… more
- Sedgwick (Orlando, FL)
- …various specialized services such as subrogation, fraud evaluation or case management review to resolve claims . + Establishes and maintains effective ... medical knowledge to properly assess the indemnity, medical and expense exposure of assigned claims ...indemnity, medical and expense exposure of assigned claims and appropriately interprets and applies insurance coverage. +… more