• Medical Claims Examiner

    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. **Essential Duties and Responsibilities:** +… more
    CHS (08/08/25)
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  • Medical Director - Florida

    Humana (Tallahassee, FL)
    …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... focus on collaborative business relationships, value based care, population health , or disease or care management. Medical ...population health , or disease or care management. Medical Directors support Humana values, and Humana's Bold Goal… more
    Humana (07/29/25)
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  • Medical Director - NorthEast Region

    Humana (Tallahassee, FL)
    …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical management organizations, hospitals/ Integrated Delivery Systems, health more
    Humana (07/25/25)
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  • Claims Rep I ( Health & Dental)

    Elevance Health (Tampa, FL)
    …(word processing, spreadsheets, etc.) strongly preferred. + Previous experience working in health claims is strongly preferred. For candidates working in person ... ** Claims Representative I** **Location:** This role enables associates...: Illinois, Minnesota In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package,… more
    Elevance Health (08/29/25)
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  • Senior Liability Claims Adjuster

    CVS Health (Tallahassee, FL)
    …Qualifications** . 3+ years of experience handling complex druggist and professional medical malpractice claims with either a healthcare company, insurance ... At CVS Health , we're building a world of health...5+ years of experience handling complex druggist and professional medical malpractice claims with either a healthcare… more
    CVS Health (08/24/25)
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  • Business Architect Sr - Claims Systems

    Elevance Health (Tampa, FL)
    …an accommodation is granted as required by law. The **Business Architect Sr. - Claims Systems** will be part of Elevance Health 's National Operations Command ... **Business Architect Sr. - Claims Systems** **Location:** This role requires associates to...EdWard, OPAL, OBI, EDI. Please be advised that Elevance Health only accepts resumes for compensation from agencies that… more
    Elevance Health (08/21/25)
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  • Medical Director - Medicare Grievances…

    Humana (Tallahassee, FL)
    …us put health first** The Corporate Medical Director (CMD) relies on medical background to review health claims and preservice appeals. The Corporate ... focused on continuously improving consumer experiences **Preferred Qualifications** + Medical utilization management experience + Working with health more
    Humana (08/08/25)
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  • Medical Claims Processor - Remote

    Cognizant (Tallahassee, FL)
    …High School Diploma or equivalent is required + A minimum of 1 years of medical claims processing is required + Facets experience is highly preferred + Knowledge ... Claims Processors to join our growing team. The ** Medical ** ** Claims Processor** is responsible for the...Now and Inquiry resolution, and any basic questions regarding health coverage as stated in the Plan Document. **Role… more
    Cognizant (08/26/25)
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  • Medical Director - Medicare Grievances…

    Humana (Tallahassee, FL)
    …us put health first** The Corporate Medical Director relies on medical background and reviews health claims and preservice appeals. The Corporate ... focused on continuously improving consumer experiences **Preferred Qualifications** + Medical utilization management experience, + working with health more
    Humana (08/26/25)
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  • Medical Claims Adjudication - remote

    Cognizant (Tallahassee, FL)
    …and able to multi-task successfully? If so, please apply today! The Claims Processor, you will ensure accurate and timely adjudication of professional and ... hospital claims utilizing payer specific policies and procedures. Provide support...Now and Inquiry resolution, and any basic questions regarding health coverage as stated in the employer's plan document.… more
    Cognizant (08/01/25)
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