- CHS (Clearwater, FL)
- **Overview** **Health Insurance Medical Claims Examiner ** **(Initial Training On Site - 90 days - Remote position after training in FL)** **Must live within ... of Clearwater, FL** **Monday-Friday Schedule with daytime hours** **Responsibilities** **Summary:** The Medical Claims Examiner adjudicates medical … more
- Sedgwick (Tallahassee, FL)
- …Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Bodily Injury Claims Examiner | Remote | Dedicated Client | Complex Claims & ... Apply your examiner knowledge and experience to adjudicate complex customer claims in the context of an energetic culture. + Deliver innovative customer-facing… more
- Sedgwick (Miami, FL)
- …to Work(R) Fortune Best Workplaces in Financial Services & Insurance Workers Compensation Claims Examiner I NY license required I Remote **PRIMARY PURPOSE** : ... To analyze complex or technically difficult workers' compensation claims to determine benefits due; to work with high exposure claims involving litigation and… more
- Sedgwick (Tallahassee, FL)
- …a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Examiner , Bodily Injury (Auto) **PRIMARY PURPOSE** : To analyze and ... process complex auto and bodily injury claims by reviewing coverage, completing investigations, determining liability and evaluating the scope of damages.… more
- 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 ... adjusting claims and other duties as necessary. Key Responsibilities: +...+ Working knowledge of COB and MSP preferably + Medical terminology + Computer literacy + Knowledge of current… more
- Amazon (FL)
- …program around the world across all of its various use cases. Amazon's Last Mile Claims team is seeking a talented claims professional to support our rapidly ... auto program. You will lead strategy on complex bodily injury auto claims , handling pre-litigation disputes and resolving litigated claims with cross-functional… more
- USAA (Tampa, FL)
- …multi-tasking, and problem-solving skills. + Advanced knowledge of human anatomy and medical terminology associated with bodily injury claims . + Ability to ... special and impactful. **The Opportunity** As a dedicated **Injury Examiner ** , you will be responsible to adjust complex...you will be responsible to adjust complex bodily injury claims , UM/UIM, and small business claims to… more
- MyFlorida (Tallahassee, FL)
- FINANCIAL EXAMINER /ANALYST II - 79001481 Date: May 22, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify Website ... No: 850846 Agency: Business and Professional Regulations Working Title: FINANCIAL EXAMINER /ANALYST II - 79001481 Pay Plan: Career Service Position Number: 79001481… more
- CHS (Clearwater, FL)
- … claims administration, is where submissions for payment/reimbursement/sharing from medical providers and covered individuals are reviewed, subject to cost ... **Overview** ** Claims Manager** **Servicing** **Health Insurance Policies or Benefits**...re-pricing entities, unable to be systematically "matched", auto-adjudicated, in Examiner queues waiting to be adjudicated, and in either… more
- MyFlorida (Tallahassee, FL)
- …claims or benefits eligibility determination; social or victim services; disability examiner ; claims adjuster; insurance adjuster; or case manager processing ... VICTIM COMPENSATION CLAIMS ANALYST - 41001136 Date: May 19, 2025...from victims, applicants, attorneys, centers, financial institutions, insurance carriers, medical providers, and/or criminal justice agencies to finalize determinations.… more
- 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
- City of Coral Gables, FL (Coral Gables, FL)
- …Investigates complaints regarding alleged code violations, determines validity of claims and recommends remedial action. Re-inspects as necessary. Assists and ... appointment as a Chief Building Inspector or Building Plans Examiner . Shall be certified by the Board of Rules...bargaining agreement and the City's Personnel Rules & Regulations. MEDICAL INSURANCE: Fully paid by the City (HMO Select).… more
- MyFlorida (Tampa, FL)
- …application / resume. + Three (3) years' employment experience as a Veterans' Claims Examiner or comparable title / experience counseling and handling veterans' ... all accredited organizations, state, county or others in obtaining medical information necessary to support claims for...in obtaining medical information necessary to support claims for benefits. Maintain rapport and liaison with VA… more
- MyFlorida (Tallahassee, FL)
- …Preference may be given for previous work experience with disability or insurance claims , medical office, social work or government programs. Florida Department ... perform duties that assist us with the processing of Social Security disability claims . This position requires the incumbent have good oral and written communication… more
- Sedgwick (Tampa, FL)
- …Apply your examiner knowledge and experience to adjudicate complex customer claims in the context of an energetic culture. + Deliver innovative customer-facing ... + We offer a diverse and comprehensive benefits including medical , dental vision, 401K, PTO and more beginning your...next round, a recruiter will be in touch. \#claimsexaminer # claims _As required by law, Sedgwick provides a reasonable… more
- Molina Healthcare (FL)
- …health care fraud, waste, and abuse. Duties include performing accurate and reliable medical review audits that may also include coding and billing reviews. The SIU ... with other internal departments, including Compliance, Corporate Legal Counsel, and Medical Officers in order to achieve and maintain appropriate anti-fraud… more
- MyFlorida (Daytona Beach, FL)
- … record. + Coordinate with the facility Business Manager and Veterans' Claims Examiner regarding veterans' maximum benefit entitlement and benefits being ... nurses. + Maintain contact with the Veteran's Service Officers at the VA Medical Centers, County Veterans Service Officers, local, federal and other state agencies… more
- 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