1 field claims representative jobs found in Jacksonville, FL

The Claims Advisor is responsible for the accurate and timely review, evaluation, and adjudication of credit-related claims in accordance with contractual provisions, product guidelines, company procedures, and applicable regulatory requirements. This position primarily focuses on analyzing claim documentation, validating eligibility and coverage, interpreting contract provisions, calculating benefits, and determining claim outcomes. The Claims Advisor exercises sound judgment and attention to detail when approving, adjusting, pending, requesting additional information for, or denying claims. The role requires the ability to review financial and supporting documentation, identify discrepancies or missing information, and make accurate decisions in accordance with established guidelines and authority levels. The Claims Advisor also maintains accurate claims records, supports payment processing, and escalates complex, questionable, or potentially fraudulent claims to leadership as...