- MyFlorida (Tallahassee, FL)
- …DSGI. Knowledge, Skills, and Abilities: * Experience in auditing, data analysis, or fraud detection. * Knowledge of claims processing and medical terminology. * ... HEALTH INSURANCE FRAUD ANALYST II - 72004150 Date: Aug 19,...implement algorithms to effectively data-mine within various types of claims data utilizing a variety of software applications; compile… more
- Elevance Health (Tampa, FL)
- …Investigator II** is responsible for identifying issues and/or entities that may pose potential risk associated with fraud and abuse. **How you will make an ... **Clinical Fraud Investigator II** **Location** : _Hybrid1:_ This role...in-depth investigations on identified providers as warranted. + Examines claims for compliance with relevant billing and processing guidelines… more
- Staples (Orlando, FL)
- …initiatives and programs in Supply Chain locations related to inventory loss, theft, and fraud . + Ensure appropriate internal risk controls are in place through ... associates and reduce worker's compensation costs. + Work with Risk Management to analyze accident data and develop corrective...Manage workplace violence mitigation programs. + Manage the WC claims process, in the field, and ensures compliance to… more
- Travelers Insurance Company (Tampa, FL)
- …specific activities required to effectively evaluate claims , such as Subrogation, Risk Control, nurse consultants, and fire or fraud investigators, and other ... and resolving assigned Construction Defect and Latent Property Damage claims . Provides quality claim handling throughout the claim life...facts or allegations of each case. + Consults with Manager on use of Claim Coverage Counsel as needed.… more
- Travelers Insurance Company (Tampa, FL)
- …specific activities required to effectively evaluate claims , such as Subrogation, Risk Control, nurse consultants, and fire or fraud investigators, and other ... and resolving assigned Construction Defect and latent Property Damage claims . Provides quality claim handling throughout the claim life...facts or allegations of each case. + Consults with Manager on use of Claim Coverage Counsel as needed.… more
- Elevance Health (Tampa, FL)
- …Auditor II** is responsible for identifying issues and/or entities that may pose potential risk associated with fraud and abuse. **How you will make an impact:** ... + Examines claims for compliance with relevant billing and processing guidelines...relevant billing and processing guidelines and identifies opportunities for fraud and abuse prevention and control. + Reviews and… more
- Travelers Insurance Company (Orlando, FL)
- …specific activities required to effectively evaluate claims , such as Subrogation, Risk Control, nurse consultants, and fire or fraud investigators, and other ... assigned General Liability related Bodily Injury and Property Damage claims . Provides quality claim handling throughout the claim life...facts or allegations of each case. + Consults with Manager on use of Claim Coverage Counsel as needed.… more
- Truist (Orlando, FL)
- …following job description:** Under minimal supervision of the Operations Manager , responsible for handling electronic payment exceptions, escalations, and ... related to Wire within established timeframes in order to mitigate risk . ESSENTIAL DUTIES AND RESPONSIBILITIES 1. Independently analyze, research, and process… more