- Molina Healthcare (Jacksonville, FL)
- …**Job Summary** **Job Summary** Responsible for comprehensive contract review and target claims audit review. This includes but not limited to deep dive, contract ... review and targeted claims audits related to accurate and timely implementations and maintenance of critical information on all claims and provider databases, validate data stored on databases and ensure adherence to business and system requirements of… more
- HUB International (Jacksonville, FL)
- …for new business development and existing client perpetuation, and is expected to maintain a book of accounts based on location practice. **In this role, you will:** ... **About HUB** In a rapidly changing world, HUB advises businesses and individuals on how to prepare for the unexpected. As one of the world's largest insurance brokers, our focus is dedicated to providing our customers with the peace of mind that what matters… more
- Sedgwick (Jacksonville, FL)
- …+ Evaluates insurance policies, claims forms, policies, endorsements, carrier instructions, and other records to determine insurance coverage. + Conducts thorough ... By joining Sedgwick, you'll be part of something truly meaningful. It's what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy… more
- Sedgwick (Jacksonville, FL)
- …+ Analyzes and processes complex or technically difficult general liability claims by investigating and gathering information to determine the exposure on the claim; ... By joining Sedgwick, you'll be part of something truly meaningful. It's what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy… more
- Sedgwick (Jacksonville, FL)
- …+ Processes low level workers compensation claims determining compensability and benefits due on long term indemnity claims, monitors reserve accuracy, and files ... necessary documentation with state agency. + Develops and coordinates low level workers compensation claims' action plans to resolution, return-to-work efforts, and approves claim payments. + Approves and processes assigned claims, determines benefits due, and… more
- Sedgwick (Jacksonville, FL)
- …+ 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 resolution. + Negotiates settlement of claims within designated authority. + Calculates and assigns timely and appropriate reserves to claims; manages reserve adequacy… more
- Sedgwick (Jacksonville, FL)
- …+ Adjusts claims that arise on Automobile, Homeowner and Excess Liability policies. + Develops exposures and evaluates injury claims based on damages, the insurance ... contract, company policies, and applicable state laws. + Investigates and evaluates coverage, liability and damages in handling of claims involving serious and catastrophic injuries, coverage, and other legal issues. + Ensures timely referral of suits to… more
- Allied Universal (Jacksonville, FL)
- …Allied Universal(R) is hiring a Special Investigations Unit (SIU) Investigator. Special Investigations Unit (SIU) Specialists investigate claims with red flags that ... **Company Overview:** Advance Your Career in Insurance Claims with Allied Universal(R) Compliance and Investigation Services. Allied Universal(R) Compliance and Investigation Services is the premier destination for a career in insurance claim investigation. As… more
- Thrivent Financial (Jacksonville, FL)
- …Thrivent is a different kind of financial services firm, one that puts generosity at the center of saving and investing. Here, you'll make an impact in the lives of ... the people you serve, helping them build, grow and protect financial well-being through purpose-based advice, investments, insurance, banking and generosity. At Thrivent, you'll receive the support, stability and opportunity of a Fortune 500 leader. We offer… more
- Sedgwick (Jacksonville, FL)
- …+ Supervises multiple teams of examiners, multiple product line examiners and/or several (minimum four) technical operations colleagues for a wide span of control; ... may delegate some duties to others within the unit. + Identifies and advises management of trends, problems, and issues as well as recommended course of action; informs management of new procedures and ideas for continuous process improvement; and coordinates… more
- Molina Healthcare (Jacksonville, FL)
- …**Job Summary** The Provider Claims Adjudicator is responsible for responding to providers regarding issues with claims, coordinating, investigates and confirms the ... appropriate resolution of claims issues. This role will require actively researching issues to adjudicate claims Requires knowledge of operational areas and systems. **Knowledge/Skills/Abilities** + Facilitates the resolution of claims issues, including… more
- Sedgwick (Jacksonville, FL)
- …+ Utilizes special account instructions to obtain individual customer information and adhere to instructions; identifies, initiates, and coordinates various ... By joining Sedgwick, you'll be part of something truly meaningful. It's what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy… more
- Molina Healthcare (Jacksonville, FL)
- …**Work hours will be 7am-3:30pm PST M-F** **Job Summary** Responsible for conducting various audits including, but not limited to; vendor, focal, audit the auditor. ... Confirm that documentation is clear and concise to ensure accuracy in auditing of critical information on claims ensuring adherence to business and system requirements of customers as it pertains to contracting (benefit and provider), network management,… more
- HUB International (Jacksonville, FL)
- …. Minimum of a FL 4-40; must be willing to obtain 2-20 or 20-44 P&C License if not already completed . Current with all necessary CE credits in required lines and ... states Department Account Management & Service Required Experience: 2-5 years of relevant experience Required Travel: No Travel Required Required Education: High school or equivalent Department Account Management & Service Required Experience: 2-5 years of… more
- Sedgwick (Jacksonville, FL)
- …+ Processes complex auto commercial and personal line claims, including bodily injury and ensures claim files are properly documented and coded correctly. + ... Responsible for litigation process on litigated claims. + Coordinates vendor management, including the use of independent adjusters to assist the investigation of claims. + Reports large claims to excess carrier(s). + Develops and maintains action plans to… more
- Sedgwick (Jacksonville, FL)
- …+ Analyzes and processes complex or technically difficult medical malpractice 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 resolution. + Conducts or assigns full investigation and provides report of investigation pertaining to new events, claims and legal actions + Negotiates claim settlement up… more
- Arlington Toyota (Jacksonville, FL)
- …* Evaluate Vehicle Damage: Perform thorough inspections of vehicles involved in collisions to assess the extent of the damage, including structural, mechanical, and ... Job Overview: The Collision Estimator is responsible for evaluating and estimating the damage to vehicles following accidents or collisions, preparing detailed reports for insurance purposes, and helping customers understand their repair options. The ideal… more
- Molina Healthcare (Jacksonville, FL)
- …**Job Summary** Responsible for work load assignment to the provider Claims adjudicators and senior provider claims adjudicators. Train and coach new employees. ... Provide clear and concise results on the provider claims model across all states. Monitors and controls workflow. Provides support to leadership supporting the team on researching and resolving claims issues and addressing employees escalations related to… more
- WTW (Jacksonville, FL)
- …Brokers serve as an integral interface between WTW clients and prospects and various insurance carriers in the marketplace. They advise Producers and other colleagues ... on the design of complex risk management programs for clients; present hard-to-place submissions to carriers, negotiate to secure coverage that meets client needs, oversee preparation of client proposals and maintain strong relationships with key carriers. If… more
- Acosta Group (Jacksonville, FL)
- …The **Risk Management Director** is responsible for the strategic oversight and execution of the company's insurance and risk management programs. This role leads the ... development, implementation, and continuous improvement of policies and procedures that mitigate risk exposure across the enterprise. The Director will manage a team including the Sr. Risk Claims Analysts and collaborate closely with internal stakeholders,… more