Claims Team Lead, Auto Sedgwick Claims Management Services, Inc.Claims Team Lead, AutoFLPRIMARY PURPOSE OF THE ROLE: To supervise the operation of multiple teams of examiners and technical staff for liability claims for clients; to monitor colleagues' workloads, provide training, and monitor individual claim activities; to provide technical/jurisdictional direction to examiner reports on claims adjudication; and to maintain a diary on claims in the teams including frequent diaries on complex or high exposure claims. Skills & knowledge: thorough knowledge of claims management processes and procedures for multiple product lines, excellent oral and written communication, including presentation skills, PC literate, including Microsoft Office products, leadership/management skills, analytical and interpretive skills, ability to work in a team environment, and the ability to meet or exceed Performance Competencies.
Casualty Claims Examiner AssuranceAmerica CorporationCasualty Claims ExaminerFLThe Casualty Claims Examiner will work alongside claims management, providing direction and oversight ensuring that compliance with best practices and state/local guidelines. Management reserves the right to add to, modify, or change the work assignments of the position as business needs dictate.
Senior Claims Benefit Specialist CVS Health CorpSenior Claims Benefit SpecialistFL$18.50–$42.35 / hourOur teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Review and adjust SF (self-funded), FI (fully insured), Reinsurance, and/or RX claims; adjudicates complex, sensitive, and/or specialized claims in accordance with claim processing guidelines.
NewGovernment Claims Admin 2, Remote, Business Office, FT, 08A-4:30P Baptist Health South Florida IncGovernment Claims Admin 2, Remote, Business Office, FT, 08A-4:30PMiami, FLRemote$21.66–$27.51 / hourBaptist Health is the region''s largest not-for-profit healthcare organization, with 12 hospitals, over 29,000 employees, 4,500 physicians and 200 outpatient centers, urgent care facilities and physician practices across Miami-Dade, Monroe, Broward and Palm Beach counties. Our approach is rooted in a "grow our own" philosophy, designed to help our team members build meaningful, long-term careers with us, supported by benefits that make a real difference, including: Career growth and development opportunities, with clear pathways and ongoing support.
EPIC Applications Analyst (1-4): Hospital Billing Admin and Hospital Billing Claims - IT Services - Full Time SolutionHealthEPIC Applications Analyst (1-4): Hospital Billing Admin and Hospital Billing Claims - IT Services - Full TimeFLEpic Application Analysts 2-4 require current Epic training status (certification, accreditation, and/or proficiency) in primary application required, with a combination of current Epic training statuses in additional area(s) in application maintenance and development required in upper levels. Ideal candidates will possess strong experience as analyst with expert knowledge and experience in leading system analysis with special emphasis on system methodologies, projects management and business process reengineering related to information systems required.
Claims Coordinator OneSpaWorld Holdings LimitedClaims CoordinatorCoral Gables, FLYou'll be a key point of contact between shipboard medical teams, cruise line partners, and internal stakeholders - bringing structure and follow-through to a fast-moving, detail-heavy process. OneSpaWorld is a global leader in health, wellness, and beauty services at sea and on land, operating spa and wellness centers aboard cruise ships and at destination resorts.
Lost Time Claims Specialist II (FL & GA University of Pittsburgh Medical CenterLost Time Claims Specialist II (FL & GAFLPrevious experience with the reserving and adjudication of the following: Workers' compensation lost time claims, Workers' compensation claim investigations (including subrogation and compensability decisions. The Lost Time Claims Specialist 2 will apply litigation management skills to aggressively manage litigation activities, budgets and claim outcomes while considering the overall impact to the customer and company.
Claims Adjudicator Miami Jewish Health Systems IncClaims AdjudicatorMiami, FLCompletes all medical claims adjudication tasks twice monthly including, tracking all claims in system, verifying referrals/authorizations, entering new providers, working expectations generating remittance notices, file transmissions and mailing checks per established department protocol. Position is key to PACE's revenue and expense process, procuring Medicare rate tables, processing provider claims for expenses by service line, ensuring client enrollment for accurate capitation reimbursement from Medicaid and Medicare, generating accruals for Accounting.
NewClaims Specialist Pyramid, IncClaims SpecialistMiami, FL$15–$18 / hourFull timeBy applying to our jobs you agree to receive calls, AI-generated calls, text messages, or emails from Pyramid Consulting, Inc. and its affiliates, and contracted partners. High school diploma or equivalent required; Associate or bachelor’s degree in business, Finance, Healthcare Administration, or related field preferred.
Claims Analyst South Florida Community Care NetworkClaims AnalystSunrise, FLThis role reviews professional and facility claims, identifies payment discrepancies, evaluates claims against benefits, contracts, reimbursement methodologies, and applicable policies, and works with internal teams to resolve issues and improve claims processing. In this role, you'll use your claims expertise and analytical skills to protect payment accuracy, identify opportunities for improvement, and help strengthen the processes that support our members and providers.
Specialist, Health Claims Carnival Corp LtdSpecialist, Health ClaimsMiami, FLCarnival Corporation & plc is the world's largest leisure travel company, our mission to deliver unforgettable happiness to our guest through our diverse portfolio of leading cruise brands and island destinations, including Carnival Cruise Line, Holland America Line, Princess Cruises, and Seabourn in North America and Australia; P&O Cruises and Cunard Line in the United Kingdom; AIDA in Germany; Costa Cruises in Southern Europe. The Specialist, Health Claims serves as a key liaison between case management team, healthcare providers, insurance carrier, and internal stakeholders to facilitate timely claim resolution, monitoring high-cost cases, validate supporting documentation, and maintain appropriate financial reviews.
NewBilling & Claims Analyst Porter CaresBilling & Claims AnalystPompano Beach, FloridaDriven by robust AI analytics, Porter’s Care Guide team helps the member navigate the healthcare delivery system, secures the right support for each member’s specific needs, and directs Porter’s team of expert clinicians to perform comprehensive in-home assessments, complete with lab and diagnostic testing. Our organization operates in a payer-contracted services model — delegated services, in-home assessments, HEDIS gap closure, and risk adjustment visits — billed through Athena in a mix of penny-claim/encounter-reporting and full-cost claim arrangements.
Supervisor Physician Third Party Claims Broward HealthSupervisor Physician Third Party ClaimsFort Lauderdale, FLWe're working together to build strong communities inside and outside. Company sees the whole person and looks to support your well-being.
Claims Manager Harmony PlusClaims ManagerDoral, FloridaPosition Objective: The Credit and Collection Manager- Claims has the responsibility of leading and coordinating activities related to credit management, collections and claims administration. His main objective is to ensure efficiency in the recovery of outstanding accounts and the effective resolution of claims, thus contributing to cash flow and customer satisfaction.
Engagement Lead - Risk Consulting- Forensic Accounting/Claims-Remote /Hybrid - US Locations Marsh McLennanEngagement Lead - Risk Consulting- Forensic Accounting/Claims-Remote /Hybrid - US LocationsMiami, FloridaRemoteAs an Engagement Lead – Forensic Accounting & Claims Services Consultant, you will act as a recognized subject matter expert, leading large-scale strategic projects, coaching team members, and solving complex client problems. We aim to attract and retain the best people and embrace diversity of age background, disability, ethnic origin, family duties, gender orientation or expression, marital status, nationality, parental status, personal or social status, political affiliation, race, religion and beliefs, sex/gender, sexual orientation or expression, skin color, veteran status (including protected veterans), or any other characteristic protected by applicable law.
Property & Casualty Liability Claims Manager (Remote - Florida) Davies Group LtdProperty & Casualty Liability Claims Manager (Remote - Florida)FLRemote$120,000–$140,000 / yearThis individual will lead a team of claims professionals managing complex liability exposures, ensuring compliance, quality, and efficiency in claims outcomes while supporting strategic business initiatives across the Davies organization. You will serve as a key member of Davies' leadership team, responsible for overseeing liability claims operations and driving excellence in technical claims handling, client service, and operational performance.
NewField Claim Representative Solera Holdings LLCField Claim RepresentativeFLOur 6,500 team members foster an uncommon, innovative culture and are dedicated to successfully bringing the future to bear today through cognitive answers, insights, algorithms and automation. Strong problem solving, project management skills while maintaining excellent customer service with client policyholder and insurance company claim staff.
Corporate Claim Litigation Attorney Expert (Remote) Allstate Insurance CompanyCorporate Claim Litigation Attorney Expert (Remote)FLRemote$130,000–$180,000 / yearClaim Litigation Counsel will be expected to provide advice and counsel to the Claims Organization regarding insurance claims of heightened exposure, complex extra-contractual matters, bad faith, and other major claim-related litigation. The ideal candidate will have at least 7 years of relevant substantive experience in a law firm or in-house legal department related to insurance defense work, and some experience managing or litigating bad faith or extra-contractual allegations.
NewClaim Specialist - Workers'''' Compensation Mitsui Sumitomo Insurance Company Of AmericaClaim Specialist - Workers'''' CompensationFLRemoteSummary/Job Purpose: This position is responsible to adjust assigned claims within delegated limits of authority, conduct timely and thorough investigations, handle subrogation claims, and complete fair and equitable claim settlements in accordance with MSMM Claim Handling Guidelines and/or requirements of principals regarding TPA business to ensure services are provided in a fair, equitable and timely manner. 5+ years of claims experience, including ability to successfully negotiate settlements, verify coverage, appropriately set reserves, successfully complete investigations and understand rules associated with state regulations.
NewSalvage Claim Representative I AAA Southern New EnglandSalvage Claim Representative IFLBy continuing to invest in more advanced technology, pursuing innovative products, and hiring a highly skilled workforce, AAA continues to build upon its heritage of providing quality service and helping our members enjoy life's journey through insurance, travel, financial services, and roadside assistance. Important Note: ACG's Compensation philosophy is to provide a market-competitive structure of fair, equitable and performance-based pay to attract and retain excellent talent that will enable ACG to meet its short and long-term goals.