Florida PIP Claims Adjuster
7 days ago
We are seeking a highly skilled and experienced Medical Adjuster to join our team at Embark MGA. As a Medical Adjuster, you will be responsible for handling Florida PIP claims, including investigations and demand handling.
Key Responsibilities- Handle Florida PIP claims, including investigations and demand handling.
- Prior experience in handling Florida PIP, Medical Payments and First Party Benefits, including medical knowledge and technical compliance requirements.
- Make appropriate coverage decisions by applying statute and case law.
- Submit files for Peer Review when necessary.
- Review bills received for compliance, peer reviews, etc.
- Work in tandem with the SIU Department and Department of Insurance Fraud Division.
- Handle cases involving attorney representation.
- Excellent organizational and workflow skills.
- A personal drive for excellence and proven track record of excellence.
- Excellent communication skills both oral and written.
- Proven ability to interact with team, peers and management to create a positive environment and achieve common goals.
- Refer cases to the Subrogation Department for recovery when applicable.
- High School Diploma.
- Minimum 2 years of Florida PIP handling experience required.
- Valid Florida Adjuster license required.
- Must be proficient in Microsoft Office.
- Excellent interpersonal and verbal/written communication skills.
- Ability to make effective decisions on behalf of the organization.
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Insurance Claims Specialist
3 weeks ago
Miami, Florida, United States NO STRESS CLAIMS Full timeUnlock Your Potential as a Public AdjusterAre you passionate about helping others and building a rewarding career? NO STRESS CLAIMS is seeking motivated individuals to join our team as Public Adjusters.What We Offer:Competitive Compensation: Enjoy a lucrative salary and commission package.Comprehensive Training: Develop the skills you need to succeed in this...
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Multi-Line Claims Adjuster
2 weeks ago
Miami, Florida, United States Property Claim Professionals Full timeJob DescriptionWe are seeking a highly skilled and experienced Multi-Line Claims Adjuster to join our team at Property Claim Professionals. As a Multi-Line Claims Adjuster, you will be responsible for investigating and adjusting property and liability claims, ensuring that our clients receive fair and timely settlements.Key Responsibilities:Investigate...
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Insurance Claims Specialist
7 days ago
Miami, Florida, United States NO STRESS CLAIMS Full timeJob OpportunityWe are seeking a skilled Public Adjuster to represent policyholders in claims negotiations and assess property damage.Key Responsibilities:Represent policyholders in claims negotiations with insurance companies.Conduct thorough assessments of property damage and prepare detailed reports.Communicate effectively with clients, insurance...
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Senior Workers Compensation Claims Adjuster
2 weeks ago
Miami, Florida, United States GB - Global Full timeAbout the RoleWe are seeking a highly skilled Claims Adjuster to join our team at GB - Global. As a key member of our experienced Claims Adjuster team, you will be responsible for investigating, evaluating, and resolving complex workers compensation claims.Key ResponsibilitiesInvestigate and evaluate claims to determine liability and extent of damagesDevelop...
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Insurance Claims Adjuster
2 weeks ago
Miami, Florida, United States United Auto Insurance Full timeJob SummaryUnited Automobile Insurance Company is seeking an experienced Insurance Claims Adjuster to join our team. As an Initial Action Adjuster, you will be responsible for evaluating and processing insurance claims, assessing damage, determining liability, and negotiating settlements with policyholders or third parties.Key ResponsibilitiesConduct...
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Third Party Adverse Subrogation Claims Adjuster
2 weeks ago
Miami, Florida, United States United Auto Insurance Full timeJob DescriptionUnited Automobile Insurance Company is seeking a highly skilled Third Party Adverse Subrogation Adjuster to join our team. As a key member of our claims department, you will be responsible for investigating claims to identify recovery opportunities, pursuing reimbursement from liable third parties and their insurers, and negotiating...
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Claims Adjudicator
3 weeks ago
Miami, Florida, United States SNI Companies Full timeJob Title: Claims AdjudicatorSeeking an experienced Claims Adjudicator with hospital-setting experience to join our team at SNI Companies.Job Summary:This role will be primarily responsible for adjudicating medical and non-medical provider claims and submitting enrollments/disenrollment to Florida Medicaid and CMS.The position is crucial to our revenue and...
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Medical Claims Examiner
1 day ago
Miami, Florida, United States Staffing Now Full timeJob SummaryThis position plays a critical role in ensuring the accurate and timely processing of medical and non-medical provider claims, as well as the submission of enrollments and disenrollments to Florida Medicaid and CMS. The successful candidate will be responsible for procuring Medicare rate tables, processing provider claims for expenses by service...
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Medical Claims Examiner
3 weeks ago
Miami, Florida, United States Staffing Now Full timeJob SummaryThis position plays a critical role in ensuring the accurate and timely processing of medical and non-medical provider claims. The successful candidate will be responsible for adjudicating claims, submitting enrollments and disenrollments to Florida Medicaid and CMS, and maintaining the integrity of PACE's revenue and expense process.Key...
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Claims Adjudicator
4 weeks ago
Miami, Florida, United States Miami Jewish Health Full timeJob Title: Claims AdjudicatorMiami Jewish Health is a leading provider of healthcare and living options for aging adults in the Southeast. Our main campus is located on 20+ acres just north of mid-town Miami, and is home to our support departments like Finance, Accounting, Human Resources, Marketing and more.Job SummaryThis position is primarily responsible...
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Claims Examiner
4 weeks ago
Miami, Florida, United States CAREERXCHANGE®, Inc. Full timeJob Summary:The Claims Examiner is responsible for investigating, evaluating, and resolving general liability claims. This role involves conducting thorough investigations, analyzing coverage, and negotiating settlements. The ideal candidate has a strong background in both claim types and excels in handling complex cases. Key Responsibilities:- Conduct...
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Claims Management Specialist
1 month ago
Miami, Florida, United States CAREERXCHANGE, Inc. Full timeJob SummaryCAREERXCHANGE, Inc. is seeking a highly skilled Claims Management Specialist to join our team of professionals. As a Claims Management Specialist, you will play a critical role in managing and resolving a variety of general liability claims, with a particular emphasis on cases involving medical malpractice and other complex scenarios.Key...
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Medical Claims Specialist
3 weeks ago
Miami, Florida, United States Lennar Homes Full timeJob Title: Medical Claims ProcessorWe are seeking a highly skilled Medical Claims Processor to join our team at Lennar Homes. As a Medical Claims Processor, you will play a critical role in supporting the Director of Risk Management and Risk Manager in all aspects of the Corporate Risk Management program.Key Responsibilities:Analyze and manage Workers'...
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Claims Risk Manager
4 weeks ago
Miami, Florida, United States Lennar Homes Full timeAbout the RoleWe are seeking a highly skilled Claims Risk Manager to join our team at Lennar Homes. As a key member of our Risk Management department, you will play a critical role in protecting the financial assets of our company.Key ResponsibilitiesManage Workers Compensation claim activity from initial claim notice to claim conclusion, ensuring a timely...
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Medical Claims Collector
1 week ago
Miami, Florida, United States Baptist Health Enterprises Full timeJob SummaryWe are seeking a highly skilled Medical Claims Collector to join our team at Baptist Health Enterprises. As a Medical Claims Collector, you will be responsible for collecting unpaid medical claims, training new collectors, and serving as a lead expert in the working/collections of a large queue of unpaid medical claims.Key...
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Medical Claims Specialist
3 weeks ago
Miami, Florida, United States Lennar Homes Full timeJob SummaryWe are seeking a highly skilled Medical Claims Processor to join our team at Lennar Homes. As a key member of our Risk Management department, you will play a critical role in protecting the financial assets of our company.Key ResponsibilitiesAnalyze and manage Workers' Compensation, General Liability, Property, Builders Risk, and Auto...
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Claim Operations Specialist
3 weeks ago
Miami, Florida, United States Everest Insurance® Full timeAbout Everest InsuranceEverest Insurance is a leading global reinsurance and insurance provider, operating for over 50 years through subsidiaries in key markets around the world.We offer a range of products, including property, casualty, and specialty insurance, through our various operating subsidiaries.Job SummaryThis position is part of the Global Claim...
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Claim Operations Specialist
2 weeks ago
Miami, Florida, United States Everest Insurance® Full timeAbout Everest InsuranceEverest Insurance is a leading global reinsurance and insurance provider, operating for over 50 years through subsidiaries in Bermuda, Canada, Europe, Singapore, the US, and other territories.We offer a range of products, including Property, Casualty, and specialty products, through our various operating subsidiaries located in key...
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Head of Athletic Medicine
1 month ago
Miami Gardens, Florida, United States Florida Memorial University Full timeThe Head of Athletic Medicine is tasked with overseeing the comprehensive sports medicine program, which encompasses injury prevention initiatives, assessments, management, treatment, rehabilitation, educational outreach, and counseling for student-athletes. This role will report directly to the Associate Athletic Director of Internal Operations.Key...
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CRNA Opportunities in Jupiter, Florida
3 weeks ago
Miami, Florida, United States Gastro Health Full timeAbout Gastro HealthGastro Health is a leading provider of high-quality, patient-centered anesthesia care in the beautiful state of Florida. Our team of experienced CRNAs is dedicated to delivering exceptional care in a collaborative and supportive environment.Job SummaryWe are seeking a skilled CRNA to join our team in Jupiter, Florida. As a CRNA with Gastro...