- Elevance Health (FL)
- …appropriate. + Identifies and refers cases or issues to QI, SIU, Subrogation , Underwriting, or other departments as appropriate. + Documents appropriate clinical ... information, decisions, and determinations in a timely, accurate, and concise manner. + Develops a working knowledge of member benefits, contracts, medical policy, professional standards of practice, and current health care practices. Position requirements: +… more
- Sedgwick (Tampa, FL)
- …practices and specific client service requirements; and to identify subrogation of claims and negotiate settlements. **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** ... + Analyzes and processes complex or technically difficult workers' compensation claims by investigating and gathering information to determine the exposure on the claim; manages claims through well-developed action plans to an appropriate and timely… more
- Molina Healthcare (St. Petersburg, FL)
- …+ Health claims processing background, including coordination of benefits, subrogation , and eligibility criteria. + Familiarity with Medicaid and Medicare ... claims denials and appeals processing, and knowledge of regulatory guidelines for appeals and denials. + Strong verbal and written communication skills To all current Molina employees: If you are interested in applying for this position, please apply through… more
- The Hartford (Lake Mary, FL)
- …appropriate reserving levels. + Maintain an active Diary. + Drive effective subrogation /salvage processes. + Ensure all claims handled within authority limits and in ... line with our procedures and guidelines. + Selects vendors, lawyers, independent surveyors, and monitor expenses paid too these vendors to ensure service quality. + Reviews and analyzes claim reports to identify and address trends. Develops and implements… more
- Sedgwick (Jacksonville, FL)
- …file towards prompt and appropriate resolution. + Identifies and pursues subrogation opportunities; secures and disposes of salvage. + Communicates claim ... action/processing with insured, client, and agent or broker when appropriate. + Maintains professional client relations. + Performs coverage, liability, and damage analysis on all claims assignments. **ADDITIONAL FUNCTIONS and RESPONSIBILITIES** + Performs… more
- Travelers Insurance Company (Tampa, FL)
- …resources for specific activities required to effectively evaluate claims, such as Subrogation , Risk Control, nurse consultants, and fire or fraud investigators, and ... other experts. + Verifies the nature and extent of injury or property damage by obtaining and reviewing appropriate records and damages documentation. + Maintains claim files and documents claim file activities in accordance with established procedures. +… more
- Molina Healthcare (Orlando, FL)
- …+ Claims processing background including coordination of benefits, subrogation , and/or eligibility criteria. **Preferred Education** Bachelor's Degree **Preferred ... Experience** + 3+ years Provider Claims and/or Provider Network Administration experience + Experience in Medical Terminology, CPT, ICD-9 codes, etc. + Access and Excel - intermediate skill level (or higher) To all current Molina employees: If you are… more
- Sedgwick (Miami, FL)
- …and settles both 1st and 3rd party claims. + Addresses salvage and subrogation as required by the client. + Maintains client relationships to assure repeated ... business referrals. **ADDITIONAL FUNCTIONS and RESPONSIBILITIES** + Performs other duties as assigned. + Supports the organization's quality program(s). + Travels as required. **QUALIFICATIONS** **Education & Licensing** Bachelor's degree from an accredited… more
- Sedgwick (Tallahassee, FL)
- …cost for our clients. + Identifies and investigates for possible fraud, subrogation , contribution, recovery, and case management opportunities to reduce total claim ... cost. + Represents Company in depositions, mediations, and trial monitoring as needed. + Communicates claim activity and processing with the client; maintains professional client relationships. + Ensures claim files are properly documented and claims coding is… more
- Orlando Utilities Commission (Orlando, FL)
- …emerging risks; + Oversee the evaluation and investigation of third-party and subrogation claims; + Conduct ongoing analysis of insurance needs and risk exposures; ... + Review insurance provisions in contracts and provide recommendations to ensure adequate protection of the Commission; + Consult with internal and external legal counsel in support of claims litigation; + Research, negotiate and purchase commercial insurance… more