• 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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  • Claims Examiner | General Liability…

    Sedgwick (Tallahassee, FL)
    …as a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Examiner | General Liability Property Damage | Remote As a Claims ... YOU AN IDEAL CANDIDATE?** If you have experience as a **General Liability Claims Examiner involving property damage in residential construction** and would like… more
    Sedgwick (08/27/25)
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  • Claims Examiner - Workers…

    Sedgwick (Tallahassee, FL)
    …a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Examiner - Workers Compensation REMOTE | California Experience Are you ... offering including medical , dental vision, 401K on day one. \#claimsexaminer # claims _As required by law, Sedgwick provides a reasonable range of compensation… more
    Sedgwick (08/23/25)
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  • Claims Examiner Workers Comp…

    Sedgwick (Tallahassee, FL)
    …as a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Examiner Workers Comp I Remote I SE, Central, NE regions **PRIMARY ... PURPOSE** : To analyze complex or technically difficult workers' compensation claims to determine benefits due; to work with high exposure claims involving… more
    Sedgwick (06/29/25)
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  • Claims Examiner - Auto/Bodily Injury

    Sedgwick (Tampa, FL)
    …a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Examiner - Auto/Bodily Injury **PRIMARY PURPOSE** : To analyze and ... process complex auto and commercial transportation claims by reviewing coverage, completing investigations, determining liability and evaluating the scope of… more
    Sedgwick (08/30/25)
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  • Claims Examiner II

    DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
    Position Purpose: The Claims Examiner is responsible for providing expertise and/or claims support in reviewing, researching, investigating, processing and ... written communication skills + 1 - 3 years of Health claims processing experience + Working knowledge...+ Working knowledge of COB and MSP preferably + Medical terminology + Computer literacy + Knowledge of current… more
    DOCTORS HEALTHCARE PLANS, INC. (08/23/25)
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  • Claims Team Lead, Liability

    Sedgwick (Tallahassee, FL)
    …training, and monitor individual claim activities; to provide technical/jurisdictional direction to examiner reports on claims adjudication; and to maintain a ... with management projects for the office. + Provides technical/jurisdictional direction to examiner reports on claims adjudication. + Compiles reviews and… more
    Sedgwick (09/03/25)
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  • Claims Manager

    CHS (Clearwater, FL)
    **Overview** ** Claims Manager** **Servicing** ** Health Insurance Policies or Benefits** **Summary:** Premier Administrative Solutions (PAS) is a Third-Party ... claims administration, is where submissions for payment/reimbursement/sharing from medical providers and covered individuals are reviewed, subject to cost… more
    CHS (08/08/25)
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  • Investigator

    Highmark Health (Tallahassee, FL)
    …to prevent further improper payments.Forwards case to the Credentialing and/or Medical Review Committee, law enforcement and regulatory agencies. + Responsible for ... to internal and external law enforcement and regulatory agencies, Credentialing or Medical Review Committee. + Engages in delivery of audit results and overpayment… more
    Highmark Health (08/15/25)
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  • Telephonic Case Manager

    Sedgwick (Tallahassee, FL)
    …and support systems. + Effectively communicates and builds relationships with the claims ' examiner , client, injured worker, attorney and supervisor. + Identifies ... ROLE:** While partnering with the injured worker, employer, and medical providers, create a case management strategy to facilitate...- a rewarding career making an impact on the health and lives of others, and a remote work… more
    Sedgwick (09/04/25)
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