Job Type
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Claim Operations Specialist Jobs in Tampa, FL

75 Jobs

  • 3.5
    WellCare – Tampa, FL
    NEW
    professional claims. Location: Tampa FL Idlewild Office Type: Hourly Non-Exempt Report to: Supv, ClaimsOperations Essential… Functions: Processes claims that pend for various hold reasons to assist in the final determination on claim disposition. Processes…
  • 2.8
    Acosta – Tampa, FL
    $24k-$34k(Glassdoor est.)
    NEW
    *Overview** The Claims Resolution Specialist is responsible for validating and clearing claims against promotional offers… policies and procedures. The Claims Resolution Specialist will communicate with internal and external business partners and act as a…
  • 3.5
    WellCare – Tampa, FL
    6 days ago 6d
    about claims payment policy disputes. Coordinate evaluation of change requests from clinical, financial and claimsoperation perspective… experience in claim coding, claim processing or billing in a healthcare environment Required 1 year of experience in claims coding…
  • 3.8
    USF Health – Tampa, FL
    $30k-$42k(Glassdoor est.)
    7 days ago 7d
    CLAIMS RESOLUTION SPECIALIST Clerical 20172502 Active-Full-Time N/A CUSTOMER SERVICE: Demonstrate adherence to the… prompt and accurate submission and follow-up of all third party claims. Reviews assigned accounts to determine appropriate action to…
  • 4.2
    First Acceptance – Tampa, FL
    5 days ago 5d
    As a Casualty ClaimSpecialist II, you will be responsible for the investigation, evaluation, negotiation, disposition and settlement… motorist claims, minor scaring, surgical procedures recommended but not preformed, multiple competing claims, claims with potential…
  • 3.1
    Acceptance Insurance – Tampa, FL
    6 days ago 6d
    Overview As a Casualty ClaimSpecialist II, you will be responsible for the investigation, evaluation, negotiation, disposition… motorist claims, minor scaring, surgical procedures recommended but not preformed, multiple competing claims, claims with potential…
  • 3.5
    WellCare – Tampa, FL
    13 days ago 13d
    process improvement opportunities. Report to: Supv, Claims Audit Operations Location: Tampa FL Woodland Office Type: Non-… Conducts daily quality reviews of operations department processes (i.e. eligibility, enrollment, claims processing and pricing, configuration…
  • 3.0
    ProAssurance – Tampa, FL
    $45k-$66k(Glassdoor est.)
    19 days ago 19d
    throughout the life of the claims. The ClaimsSpecialist directs the management of claims including claims investigation, coverage… searching for a ClaimsSpecialist in our Tampa, FL office. The primary responsibility of the ClaimsSpecialist position is to provide…
  • 3.5
    WellCare – Tampa, FL
    $42k-$61k(Glassdoor est.)
    11 days ago 11d
    to: Supv, Operations Department: Ops-Claims I Researches and processes institutional and professional claims. Serves as… a resource to resolve more complex claims. Essential Functions: Processes claims that pend for various hold reasons…
  • 3.5
    WellCare – Tampa, FL
    NEW
    Manages claims coding rule process. Evaluates claims coding rule change request from clinical, financial, and claimsoperations perspectives… perspective, Financial perspective, and Claimsoperational perspectives; Prepare analysis of claims coding rule changes. Seeks professional…
  • 3.5
    WellCare – Tampa, FL
    $37k-$58k(Glassdoor est.)
    6 days ago 6d
    Manages claims coding rule process. Evaluates claims coding rule change request from clinical, financial, and claimsoperations perspectives… perspective, and claimsoperational perspectives. Seeks professional feedback from Health Services, Finance, and Claims on claims coding…
  • 3.6
    Infinity Insurance – Tampa, FL
    10 days ago 10d
    documents. 4. Communicates with clients, claims adjusters, litigation specialists, attorneys' offices, medical provider offices… includes handling litigation involving bodily injury, UM, glass claims, subrogation and recovery, bodily injury, property damage, and…
  • 2.6
    AAA The Auto Club Group – Tampa, FL
    $38k-$56k(Glassdoor est.)
    14 days ago 14d
    and complex claims. Claim handling responsibilities will include the following: reviewing assigned claims, contacting the… Recovery Units or Claims Special Investigation Unit). Thoroughly document and/or code the claim file and complete all claim closure and…
  • 3.2
    Healthesystems – Tampa, FL
    $31k-$45k(Glassdoor est.)
    HOT
    Supervisor and Manager to resolve phone inquiries related to claims adjudication, eligibility verification, prior authorization… The role of the Customer Service Specialist is to build trusted relationships with our clients, their claimants and our vendor…
  • 3.5
    WellCare – Tampa, FL
    $34k-$60k(Glassdoor est.)
    6 days ago 6d
    such as Health Services, Provider Relations, Sales, Vendors, Claims Beginner Other Demonstrate ability to implement process improvements… implementations, quality reviews, root cause analysis, training, operational processes, etc. Maintains/ Creates resources applicable…
  • 3.7
    Progressive Insurance – Tampa, FL
    $42k-$56k(Glassdoor est.)
    HOT
    demonstrated core competence as a ClaimsSpecialist Int or Claims Generalist Int negotiating injury claims. - Ability to quickly build… recommendations and plans for litigated claims. No supervisory authority. Operates with high authority limits consistent with…
  • 3.0
    AAA Auto Club – Tampa, FL
    $47k-$69k(Glassdoor est.)
    30+ days ago 30d+
    issues and complex claims. Claim handling responsibilities will include the following: reviewing assigned claims, contacting the… Recovery Units or Claims Special Investigation Unit). Thoroughly document and/or code the claim file and complete all claim closure and…
  • 3.5
    MEMIC – Tampa, FL
    $55k-$85k(Glassdoor est.)
    24 days ago 24d
    Oversee specific unit personnel including Claimspecialist, associates and assistants. Responsibilities include overseeing the… implementing strategies related to the quality and function of the claimoperation in an efficient, cost effective manner. Additional duties…
  • 4.2
    University of South Florida – Tampa, FL
    $35k-$44k(Glassdoor est.)
    5 days ago 5d
    How to Claim Vet Preference This position allows eligible veterans and their spouses to claim Veterans’ Preference… Preference pursuant to Florida Statute 295. Applicants claiming preference are responsible for providing required documentation…
  • 3.5
    Wellcare – Tampa, FL
    $44k-$61k(Glassdoor est.)
    7 days ago 7d
    Answers CSR claim inquiries via live transfer and resolves issues real time. Thoroughly researches post payment claims and takes… as it relates to claims processing. Resolve critical errors as it relates to rejections, coding denials, claims processing and…
  • 3.2
    American Integrity Insurance – Tampa, FL
    13 days ago 13d
    representative. The Litigation Specialist must have a solid understanding of property (personal lines) insurance claims handling practices… preferably with knowledge of Florida claims handling rules and standards. The Litigation Specialist must understand, and have the ability…
  • 3.5
    WellCare – Tampa, FL
    $44k-$61k(Glassdoor est.)
    7 days ago 7d
    Answers CSR claim inquiries via live transfer and resolves issues real time. Thoroughly researches post payment claims and takes… it relates to claims processing. Resolve critical errors as it relates to rejections, coding denials, claims processing and…
  • 3.5
    WellCare – Tampa, FL
    6 days ago 6d
    SATs as needed. Resolves critical errors forwarded from the claims department. Updates tracking database. Builds and maintains… billing practices Technical Skills/Requirements: Knowledge of Claims Processing Knowledge of CPT/HCPCS coding Knowledge of Access…
  • 4.2
    University of South Florida – Tampa, FL
    $25k-$38k(Glassdoor est.)
    11 days ago 11d
    How to Claim Vet Preference This position allows eligible veterans and their spouses to claim Veterans’ Preference… Preference pursuant to Florida Statute 295. Applicants claiming preference are responsible for providing required documentation…
  • 3.4
    Hillsborough County (Florida) – Tampa, FL
    $44k-$68k(Glassdoor est.)
    NEW
    ; resolving minor conflicts at construction site; reviewing claims submitted by contractors; and performing interim and final inspections… throughout each step of the selection process. The applicant claiming veterans' preference is responsible for providing required…
  • 3.4
    Quality Distribution – Tampa, FL
    6 days ago 6d
    workers comp claim into the claims system. When responding to accidents or incidents, the Call Center Specialist will be responsible… Title Call Center Specialist City Tampa State FL Description Quality Distribution is the operating company for Quality…
  • 3.4
    Humana – Tampa, FL
    $30k-$44k(Glassdoor est.)
    HOT
    Service Operations – provide perfect service and guidance to members. CarePlus is seeking a Customer Care Specialist for customer… services over the telephone prioviding benefit, eligibility, claims and authorization inquiries. Role Essentials High…
  • 3.1
    State of Florida – Tampa, FL
    $28k-$44k(Glassdoor est.)
    NEW
    Service vacancies and are encouraged to apply. Candidates claiming Veterans Preference must attach supporting documentation with… Agency: Department of Health Working Title: ENVIRONMENTAL SPECIALIST II - 64006980 Position Number: 64006980 Salary:…
  • 3.1
    State of Florida – Tampa, FL
    $38k-$59k(Glassdoor est.)
    NEW
    vacancies and are encouraged to apply. However, applicants claiming Veterans Preference must attach supporting documentation with… Service vacancies and are encouraged to apply. Candidates claiming Veterans Preference must attach supporting documentation with…
  • 2.8
    Co-Advantage Resources – Tampa, FL
    $31k-$49k(Glassdoor est.)
    6 days ago 6d
    . Scanning/filing and other special projects as needed. Claims resolutions and employee assistance. Cobra. Regular attendance… employees in an efficient and professional manner. Ability to operate computer hardware and to work with software applications.…
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