NewClaims Specialist - Professional Liability Philadelphia Insurance CompaniesClaims Specialist - Professional LiabilityLake Mary, FL$95,000–$105,000 / yearEvaluates each claim in light of facts; Affirm or deny coverage; investigate to establish proper reserves; and settles or denies claims in a fair and expeditious manner. Marketing Statement: Philadelphia Insurance Companies, a member of the Tokio Marine Group, designs, markets and underwrites commercial property/casualty and professional liability insurance products for select industries.
Claims Specialist - Property Philadelphia Insurance CompaniesClaims Specialist - PropertyLake Mary, FL$84,422–$99,320 / yearEvaluates each claim in light of facts; Affirm or deny coverage; investigate to establish proper reserves; and settles or denies claims in a fair and expeditious manner. Marketing Statement: Philadelphia Insurance Companies, a member of the Tokio Marine Group, designs, markets and underwrites commercial property/casualty and professional liability insurance products for select industries.
Insurance Claims Specialist (Construction Defects and Property Damage) DPR Construction IncInsurance Claims Specialist (Construction Defects and Property Damage)Orlando, FLKey Skills: • Basic working knowledge and familiarity of: • Commercial General Liability • Property Insurance (Including Inland Marine and Builder's Risk) • Pollution Liability • Professional Liability • Controlled Insurance Programs (CCIP/OCIP) • RMIS Systems • Construction Industry Expertise • Strategic thinking • Strong written and oral communication skills • High level of EQ (Soft skills) • Self-Starter • Highly organized and responsive; ability to meet deadlines • Detail Oriented • Contractual risk assessment • Dispute management • Integrity • Ability to mentor and inspire others • Team player • Willingness to understand and advance the DPR Culture • Proactive Learner. Act as a liaison between all parties involved, including but not limited to, carriers, clients, trade partners, brokers, consultants, attorneys and DPR project teams (and DPR-related entities), as it relates to claim progress, strategy, expenses, and settlements.
Senior Casualty Claims Specialist - Southeast Liberty Mutual Holding Company IncSenior Casualty Claims Specialist - SoutheastLake Mary, FLRemoteThe full salary range for this role reflects the competitive labor market value for all employees in these positions across the national market and provides an opportunity to progress as employees grow and develop within the role. Some roles at Liberty Mutual have a corresponding compensation plan which may include commission and/or bonus earnings at rates that vary based on multiple factors set forth in the compensation plan for the role.
Auto and General Liability Claims Specialist The Hartford Insurance Group IncAuto and General Liability Claims SpecialistLake Mary, FL$107,600–$161,400 / yearProviding support to field offices to assist field personnel with coverage and liability analysis, time limit demands, extra contractual exposure evaluations and other issues of complexity; Work with business partners to evaluate and address claim trends and developments; and. Candidates who live near one of our office locations (Hartford, CT, San Antonio, TX, Lake Mary, FL, Scottsdale, AZ, Alpharetta, GA, and Naperville, IL) will have the expectation of working in an office 3 days a week (Tuesday through Thursday).
Litigated Claims Specialist (General Liability) Zurich Insurance Group LtdLitigated Claims Specialist (General Liability)Maitland, FLOur hybrid work model is thoughtfully designed around employee needs offering autonomy to complete focused work from a preferred location, while still supporting meaningful in-person collaboration when it adds value. You will follow established best practices and protocols to ensure claims are handled efficiently and effectively, while delivering a consistent, high-quality, and customer-focused claims experience.
NewClaims Specialist II - Veterans Disability Appeals AllsupClaims Specialist II - Veterans Disability AppealsOrlando, FloridaAccesses claimant’s record on the system (past notes, completed fields, actions); interprets, gathers, and conveys information to the caller (claimant, VA and Board of Veterans Affairs). Obtains information regarding other services/programs that might be helpful to the claimant such as health insurance assistance, Medicare, state funded programs (welfare) and other local resources.
Claims Specialist II, Workers Compensation Zurich Insurance Group LtdClaims Specialist II, Workers CompensationMaitland, FLThe Workers Compensation Claims Specialist will handle multi-party commercial line Workman's Compensation claims of moderate to high exposure and complexity within specific authority limits, to ensure that claims are handled in the most efficient, effective way while delivering a customer-centric claims service. In this role you will be responsible for: Document claims file by accurately capturing and updating claims data/information in compliance with best practices for commercial line claims of moderate to high exposure and complexity.
General Liability Claims Specialist CNA Financial CorpGeneral Liability Claims SpecialistFL$54,000–$103,000 / yearJOB DESCRIPTION: Essential Duties & Responsibilities: Performs a combination of duties in accordance with departmental guidelines: Manages an inventory of moderate to high complexity and exposure commercial claims by following company protocols to verify policy coverage, conduct investigations, develop and employ resolution strategies, and authorize disbursements within authority limits. Conducts focused investigation to determine compensability, liability and covered damages by gathering pertinent information, such as contracts or other documents, taking recorded statements from customers, claimants, injured workers, witnesses, and working with experts, or other parties, as necessary to verify the facts of the claim.
Commercial Auto Claims Specialist CNA Financial CorpCommercial Auto Claims SpecialistLake Mary, FL$54,000–$103,000 / yearJOB DESCRIPTION: Essential Duties & Responsibilities: Performs a combination of duties in accordance with departmental guidelines: Manages an inventory of moderate to high complexity and exposure commercial claims by following company protocols to verify policy coverage, conduct investigations, develop and employ resolution strategies, and authorize disbursements within authority limits. Conducts focused investigation to determine compensability, liability and covered damages by gathering pertinent information, such as contracts or other documents, taking recorded statements from customers, claimants, injured workers, witnesses, and working with experts, or other parties, as necessary to verify the facts of the claim.
Commercial Auto & General Liability Claims Specialist, Construction CNA Financial CorpCommercial Auto & General Liability Claims Specialist, ConstructionLake Mary, FLJOB DESCRIPTION: Essential Duties & Responsibilities: Performs a combination of duties in accordance with departmental guidelines: Manages an inventory of moderate to high complexity and exposure commercial claims by following company protocols to verify policy coverage, conduct investigations, develop and employ resolution strategies, and authorize disbursements within authority limits. Conducts focused investigation to determine compensability, liability and covered damages by gathering pertinent information, such as contracts or other documents, taking recorded statements from customers, claimants, injured workers, witnesses, and working with experts, or other parties, as necessary to verify the facts of the claim.
Commercial Auto & General Liability Claims Specialist, Construction CNACommercial Auto & General Liability Claims Specialist, ConstructionLake Mary, FloridaEssential Duties & Responsibilities: Performs a combination of duties in accordance with departmental guidelines: Manages an inventory of moderate to high complexity and exposure commercial claims by following company protocols to verify policy coverage, conduct investigations, develop and employ resolution strategies, and authorize disbursements within authority limits. Conducts focused investigation to determine compensability, liability and covered damages by gathering pertinent information, such as contracts or other documents, taking recorded statements from customers, claimants, injured workers, witnesses, and working with experts, or other parties, as necessary to verify the facts of the claim.
NewSr. Claims Specialist, Workers Compensation Zurich Insurance Group LtdSr. Claims Specialist, Workers CompensationMaitland, FLKey Responsibilities: Document claims file by accurately capturing and updating claims data/information in compliance with best practices for single and multi-party personal or commercial line claims of moderate to high exposure and complexity. This is an exciting opportunity to manage complex, multi-party commercial Workers Compensation claims with moderate to high exposure and make a meaningful impact through your expertise.
Senior Casualty Claims Resolution Specialist - Central/Southwest Region Liberty Mutual Holding Company IncSenior Casualty Claims Resolution Specialist - Central/Southwest RegionOrlando, FLRemoteOur Complex Casualty Claims Team is expanding, and we're seeking a Senior Claims Resolution Specialist who brings deep technical expertise, sharp critical thinking, and a passion for doing what's right. The full salary range for this role reflects the competitive labor market value for all employees in these positions across the national market and provides an opportunity to progress as employees grow and develop within the role.
Surety Claim Specialist FCCI Insurance GroupSurety Claim SpecialistLake Mary, FL$102,357–$157,629 / yearThe Surety Claim Specialist will independently conduct due diligence, evaluate exposure, and represent Suretys interests with adverse parties and proactively respond to the most complex demands against contract and commercial surety bonds. Actively solicits facts from all stakeholders, analyze bond forms and construction contracts, reviews applicable statutes, and analyzes claim submissions involving commercial and contract surety bonds.
Multi-Line Claim Specialist (Product) CCMSIMulti-Line Claim Specialist (Product)Maitland, Florida$68,500–$85,000 / yearAt CCMSI, we partner with global clients to solve their most complex risk management challenges, delivering measurable results through advanced technology, collaborative problem-solving, and an unwavering commitment to their success. The Multi-Line Claim Specialist position is responsible for the investigation and adjustment of general liability claims for a dedicated client account handling a variety of coverages, including bodily injury and product liability.
NewComplex Claims Consultant/Specialist - Lawyers Professional Liability CNA Financial CorpComplex Claims Consultant/Specialist - Lawyers Professional LiabilityLake Mary, FL$72,000–$141,000 / yearPerforms a combination of duties in accordance with departmental guidelines: Manages an inventory of highly complex commercial claims, with large exposures that require a high degree of specialized technical expertise and coordination, by following company protocols to verify policy coverage, conduct investigations, develop and employ resolution strategies, and authorize disbursements within authority limits. Resolves claims by collaborating with internal and external business partners to develop, own and execute a claim resolution strategy, that includes management of timely and adequate reserves, collaborating with coverage experts, negotiating complex settlements, partnering with counsel to manage complex litigation and authorizing payments within scope of authority.
Bodily Injury Claim Specialist - CCU The Hartford Insurance Group IncBodily Injury Claim Specialist - CCULake Mary, FL$121,000–$140,000 / yearThese claims will involve both primary and excess coverages and often involve complex fact patterns requiring analysis of contracts between parties to determine indemnity and contribution obligations and risk transfer opportunities. As a Claims Specialist, you will be responsible for handling a caseload of higher complexity, higher exposure, bodily injury, and construction related bodily injury claims from inception to final disposition.
NewClaims Representative I Elevance Health IncClaims Representative ILake Mary, FL$16.23–$24.36 / hourPreferred Skills, Capabilities and Experiences: Good oral and written communication skills, previous experience using PC, database system, and related software (word processing, spreadsheets, etc.) strongly preferred. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
NewBristol West Claims Liability Claims Representative-Hybrid Farmers Group, Inc.Bristol West Claims Liability Claims Representative-HybridLake Mary, FLRemoteTrains to interact professionally and courteously with stakeholders including policyholders, claimants, agents, witnesses, repair fa cilities, contractors, police and fire departments, state and country fraud and arson specialists, special investigators, attorneys, medical professionals and other persons incident to the investigation and processing of claims. Learns skills such as conducting thorough i nvestigations, establishing damages, determining liability, negotiating settlements, making claim payments, confirming policy coverage, and explaining claim determination to parties incident to the claim.
Client Care Center-Consumer Account Security Claims Truist BankClient Care Center-Consumer Account Security ClaimsOrlando, FloridaGeneral Description of Available Benefits for Eligible Employees of Truist Financial Corporation: All regular teammates (not temporary or contingent workers) working 20 hours or more per week are eligible for benefits, though eligibility for specific benefits may be determined by the division of Truist offering the position. Committed to utilize all available tools and resources to curate a differentiated client experience, track all unresolved issues accurately, to ensure timely follow up and resolution.
Client Care Center-Consumer Account Security Claims Truist Financial CorpClient Care Center-Consumer Account Security ClaimsOrlando, FLGeneral Description of Available Benefits for Eligible Employees of Truist Financial Corporation: All regular teammates (not temporary or contingent workers) working 20 hours or more per week are eligible for benefits, though eligibility for specific benefits may be determined by the division of Truist offering the position. Committed to utilize all available tools and resources to curate a differentiated client experience, track all unresolved issues accurately, to ensure timely follow up and resolution.
PreAccess Oncology Benefits and Authorization Specialist AdventHealthPreAccess Oncology Benefits and Authorization SpecialistMaitland, FL$17.63–$28.20 / hourResponsible for communicating to service line partners of situations where medical necessity is not met to include review of journal articles, compendia and/or peer review to justify medical necessity approval Reviews clinical records when following up on authorization request directly with a payor. Reviews clinical data such as patient pathology reports, scans, laboratory results, prior treatments, matching against insurance payor and/or National Comprehensive Cancer Network (NCCN guidelines.
Remote Medical Billing Specialist TRC Talent SolutionsRemote Medical Billing SpecialistWinter Park, FLRemote$18–$22 / hourTemporaryIf you thrive in a fast-paced environment, enjoy problem solving, and have experience working insurance denials and unpaid claims, we'd love to hear from you. Our team partners with healthcare providers and hospital organizations to deliver revenue cycle and accounts receivable support services.
NewCredit and Collection Specialist - Patient Accounts Elevance HealthCredit and Collection Specialist - Patient AccountsLake Mary, FloridaWe are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. Location: T his role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance.
NewAccounts Payable/Receivable Specialist II University of Central FloridaAccounts Payable/Receivable Specialist IIOrlando, FL$17.64–$21.61 / hourThe Opportunity: The Accounts Payable/Receivable Specialist II is responsibilities for communicating with insurance companies to follow up on outstanding accounts receivable, insurance denial management, submitting and re-billing insurance claims, posting insurance and patient payments, and working with patients to resolve balances and billing challenges. As a next-generation public research university and Forbes-ranked top employer in Florida, we are a community of thinkers, doers, creators, innovators, healers, and leaders striving to create broader prosperity and help shape a better future.
NewTPA Service Specialist TravelGuard Zurich NATPA Service Specialist TravelGuardMaitland, FLDesigned with our employees' needs in mind, the ZNA Claims hybrid work model emphasizes flexibility, allowing claims employees to conduct individual work in their preferred location, while facilitating in-person connections and collaborative activities when meaningful and valuable. In this role you will be responsible for collaborating with our Zurich CoverMore (Travel Guard/ Travelex) partners regarding the oversight of the TPAs that adjudicate claims on travel policies.
Dental Billing Specialist @ Dental Specialty Center Haines City Dental Care Alliance, LLCDental Billing Specialist @ Dental Specialty Center Haines CityDavenport, FLCompetitive wages, great benefits, and opportunities for advancement are just a few reasons why a career with us is an investment in your future; make Dental Care Alliance your employer of choice. Dental Specialty Center of Haines city is currently looking for a Dental Billing Specialist for our office located in Davenport,Fl .
Trust and Safety Specialist Zeel Networks IncTrust and Safety SpecialistOrlando, FLRemoteA proud member of the VA Community Care Network, Zeel provides Medical Massage Therapy for veterans suffering from acute and chronic pain, PTSD, and other life-limiting conditions. This role manages escalations from patients and providers, documents and mitigates potential risks, assists in policy development, and supports credentialing and quality assurance processes.
Medical Billing & Collections Specialist (Quality Assurance) Rotech Healthcare Inc.Medical Billing & Collections Specialist (Quality Assurance)Orlando, FLCorrects any errors identified by the Claims Supervisor, enters IMBS audit control number located on "Maintenance Audit Report", verifies in the system that there is an AOB for each claim, files the "Maintenance Audit Report", and identifies any claims that will release during the nightly cycle, makes copies of necessary forms, and identifies Cash Sale Delivery tickets. Prints the "Maintenance Audit Report" from the system and verifies that the information in the report is accurate; attaches the audit report to supporting documents; submits the packet to the Claims Supervisor for review prior to entering Audit Control.
Credit and Collection Specialist - Patient Accounts Elevance Health IncCredit and Collection Specialist - Patient AccountsLake Mary, FLWe are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. Job Description: Location: T his role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance.
Hospital Coding Specialist Sr-Inpatient Orlando Health Ventures l LLCHospital Coding Specialist Sr-InpatientOrlando, FLLicensure/Certification Must maintain one of the following: • Certified Coding Specialist (CCS) • Certified Professional Coder (CPC) • Certified Outpatient Coder (COC) • Registered Health Information Administrator (RHIA) - preferred but not required • Registered Health Information Technician (RHIT) - preferred but not required • Registered Health Information Administrator (RHIA) • Registered Health Information Technician (RHIT) • Certified Coding Specialist (CCS) Experience • Five (5) years previous hospital inpatient and/or outpatient coding experience required. Responsibilities Essential Functions • Perform high level review and analysis of clinical documentation and accurately assign diagnosis and procedure codes for multifacility all levels of inpatient visits using ICD-10-CM/PCS classification systems+, utilizing EPIC Electronic Medical Record (EMR), encoder, computer assisted coding (CAC), and other applications as applicable.
NewBilingual Patient Access Specialist (English/Spanish) AssistRxBilingual Patient Access Specialist (English/Spanish)Orlando, FL$19–$22 / hourA Day in the Life as a Bilingual Patient Access Specialist: This role works directly with healthcare providers & insurance plans/payers to gather information about a patient's insurance and the coverage provided for a specific pharmaceutical product. Why Choose AssistRx: Work Hard, Play Hard: Preloaded PTO: 100 hours (12.5 days) PTO upon employment, increasing to 140 hours (17.5 days) upon anniversary.
Patient Access Specialist AssistRxPatient Access SpecialistOrlando, FL$40,000–$50,000Teamwork - Balances team and individual responsibilities; Exhibits objectivity and openness to others' views; Gives and welcomes feedback; Contributes to building a positive team spirit; Puts success of team above own interests; Able to build morale and group commitments to goals and objectives; Supports everyone's efforts to succeed. Professionalism - Approaches others in a tactful manner; Reacts well under pressure; Treats others with respect and consideration regardless of their status or position; Accepts responsibility for own actions; Follows through on commitments.
Insurance Verification Specialist - Specialty Pharmacy AssistRxInsurance Verification Specialist - Specialty PharmacyMaitland, FLRemote$39,520–$45,760Conduct benefit investigations for patients by making outbound phone call to payers to verify patient insurance benefit information, navigate complex reimbursement barriers and seek resources to overcome the barriers. This role works directly with healthcare providers & insurance plans/payers to gather information about a patient’s insurance and the coverage provided for a specific pharmaceutical product.
Insurance Credit & Collections Specialist Elevance Health IncInsurance Credit & Collections SpecialistLake Mary, FLWe are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. Minimum Requirements: Requires a H.S. diploma or equivalent and a minimum of 1 year of prior commercial debt collection experience; or any combination of education and experience, which would provide an equivalent background.
Hospital Coding Specialist Sr Orlando Health Ventures l LLCHospital Coding Specialist SrOrlando, FLThrough our award-winning hospitals and ERs, specialty institutes, urgent care centers, primary care practices, and outpatient facilities, our 27,000 team members serve communities that span Floridas east to west coasts and beyond. • Must maintain one of the following: • Registered Health Information Administrator (RHIA) • Registered Health Information Technician (RHIT) • Certified Coding Specialist (CCS) • Coding Associate (CCA) by the American Health Information Management Association (AHIMA) - renewed every 2 years.
Specialist, Appeals & Grievances (Must live in TX and Medicaid experience) Molina Healthcare IncSpecialist, Appeals & Grievances (Must live in TX and Medicaid experience)Orlando, FLRequests and reviews medical records, notes, and/or detailed bills as appropriate; formulates conclusions per protocol and other business partners to determine response; assures timeliness and appropriateness of responses per state, federal and Molina guidelines. Facilitates comprehensive research and resolution of appeals, disputes, grievances, and/or complaints from Molina members, providers, and related outside agencies to ensure that internal and/or regulatory timelines are met.
Pharmacy Billing Specialist Guardian Pharmacy Services ManagementPharmacy Billing SpecialistOrlando, FloridaOur core focus is delivering customized medication management solutions to support healthcare organizations serving seniors and individuals with complex care needs. With our comprehensive suite of tech-enabled pharmacy services and a dedicated team of professionals committed to enriching the lives of those we serve, we are redefining how pharmacy care is delivered.
Medical Billing Specialist Collins Consulting IncMedical Billing SpecialistLake Mary, FLUses available resources to maintain current regulatory guidelines and reimbursement information to ensure that the company is obtaining all appropriate information as required for billing and reimbursement. Manages the entry of client information into computer system in a timely manner and contact of referral source, customer, and/or client to obtain missing information needed to set up client for service.
RISK MANAGEMENT PROGRAM SPECIALIST - 43000192 Government of FloridaRISK MANAGEMENT PROGRAM SPECIALIST - 43000192ORLANDO, FL$52,000–$55,000 / yearBased on facts derived from the claims investigation and or pre-trial discovery, responsible for applying appropriate case law and making a determination of liability for the purpose of exploring the desirability of settlement; related to this responsibility is the need to properly evaluate medical reports, vendor bills, and estimates of damage; responsible for authorizing and making offers of settlement up to approved authority and denying claims when necessary. Candidates claiming Veterans' Preference must attach supporting documentation with each submission that includes character of service (for example, DD Form 214 Member Copy #4) along with any other documentation as required by Rule 55A-7, Florida Administrative Code.
Advocacy Coordination Team Specialist Sedgwick Claims Management Services, Inc.Advocacy Coordination Team SpecialistOrlando, FL$24–$27 / hourProvides excellent customer service displaying care and empathy to callers regarding claims and executes technical and jurisdictional requirements for accurate claims processing, benefit review and interpretation of regulations, financial payment processing, and error correction of complex or high exposure claims. PRIMARY PURPOSE: Actively researches, resolves, and administers escalated inquires for all lines of business, including but not limited to Family Medical Leave (FMLA), complex paid and unpaid state, military, and company-specific leaves, accommodations, disability and statutory claims.
Credentialing Specialist Sr. Orlando Health Ventures l LLCCredentialing Specialist Sr.Orlando, FLEmployee-centric Orlando Health has been selected as one of the "Best Places to Work in Healthcare" by Modern Healthcare Position Summary The Credentialing Senior Specialist provides support and acts as liaison to physicians and other medical staff department members ensuring all medical staff credentialing is acted upon in a consistent and timely manner. Through our award-winning hospitals and ERs, specialty institutes, urgent care centers, primary care practices and outpatient facilities, our 27,000+ team members serve communities that span Florida's east to west coasts and beyond.
Fraud Operations Specialist Axiom BankingFraud Operations SpecialistMaitland, FLMinimum of 2 years of banking, financial services, fraud operations, deposit operations, electronic banking, card disputes, ACH operations, wire operations, or related risk operations experience preferred; prior direct experience handling Regulation E claims, debit card disputes, ACH fraud, account takeover investigations, or payment fraud cases strongly preferred. Understanding of bank fraud typologies, including unauthorized electronic transactions, debit card fraud, ACH fraud, check fraud, wire fraud, identity theft, account takeover, elder exploitation indicators, social engineering, mule activity, and online banking compromise.
Business Development Specialist GallagherBusiness Development SpecialistLake Mary, FloridaFull timeThe actual compensation will be influenced by a wide range of factors including, but not limited to previous experience, education, pay market/geography, complexity or scope, specialized skill set, lines of business/practice area, supply/demand, and scheduled hours. Gallagher embraces our employees’ diverse identities, experiences and talents, allowing us to better serve our clients and communities.
LABOR, EMPLOYMENT & TRAINING SPECIALIST - 79011234 Government of FloridaLABOR, EMPLOYMENT & TRAINING SPECIALIST - 79011234ORLANDO, FL$1,396.82–$1,643.79 / weekCompiles and analyzes evidence of infractions through in-depth review of payroll records, conducts and interviews Subjects as necessary, prepares investigative reports of findings, and submits to the Child Labor Program staff for appropriate action. Candidates claiming Veterans' Preference must attach supporting documentation with each submission that includes character of service (for example, DD Form 214 Member Copy #4) along with any other documentation as required by Rule 55A-7, Florida Administrative Code.
Fraud Operations Specialist Axiom Bank, N.A.Fraud Operations SpecialistMaitland, FLMinimum of 2 years of banking, financial services, fraud operations, deposit operations, electronic banking, card disputes, ACH operations, wire operations, or related risk operations experience preferred; prior direct experience handling Regulation E claims, debit card disputes, ACH fraud, account takeover investigations, or payment fraud cases strongly preferred. Understanding of bank fraud typologies, including unauthorized electronic transactions, debit card fraud, ACH fraud, check fraud, wire fraud, identity theft, account takeover, elder exploitation indicators, social engineering, mule activity, and online banking compromise.
Remote Insurance Verification Specialist, Specialty (Florida) Walgreen CoRemote Insurance Verification Specialist, Specialty (Florida)Orlando, FLRemoteWalgreens has approximately 220,000 team members, including nearly 90,000 healthcare service providers, and is committed to being the first choice for pharmacy, retail and health services, building trusted relationships that create healthier futures for customers, patients, team members and communities. Intermediate level PC skills, MS Windows, MS Office Suite and/or other similar operating/software programs (for example: start up and shut down computer, use mouse to point and click, start and close programs, switch between programs, save files, print documents and/or access information on-line).
Clinical Denials Management Specialist AdventHealthClinical Denials Management SpecialistAltamonte Springs, FL$66,170.74–$123,073.07 / yearReviews various types of denial, appeal, and further action including charge audit/charge capture denials, charge correction, clinical validation, services deemed experimental, services denied according to various payer policies, inpatient level of care, NICU level of care, readmissions, etc. Technical proficiency to independently set up computer system including monitors, docking station, keyboard, and ability to maintain reliable internet service along with backup internet plan for outages, and troubleshoot / resolve problems [Required].
Field Clinical Specialist, Orlando West Terumo Medical CorpField Clinical Specialist, Orlando WestOrlando, FL$75,000–$105,000 / yearThis includes but is not limited to the prompt recognition and forwarding of customer complaints (i.e. adverse events, product performance reports, etc.) to Quality Assurance (QA), and by ensuring all promotional messaging (i.e. branding strategies, product claims, etc.) and materials (i.e. literature) discussed or presented to customers are clinically accurate and adhere to AdvaMed guidelines and Terumos policy on Interactions with Healthcare Professionals. Operate computer simulation equipment and support the use of various vessel model units during trade shows, local clinical meetings and PACE sponsored courses to assist in the delivery of education and knowledge transfer related to specific products and procedure guidance.