17 claims jobs found in Miami, FL

Gallagher Bassett is the premier provider of global claims services, dedicated to exceptional customer service and demonstrably superior outcomes. GB helps people, teams and businesses overcome adversity and loss through the guiding expertise of over 5,000 claims professionals, all committed to going beyond expectations in the continuous pursuit of a better way. Position Summary: Under direct supervision, performs basic claim handling functions to include data entry, bill payment, ordering various reports from outside parties, preparing and filing various required forms. Interacts with clients, attorneys and outside vendors for various reasons including but not limited to gathering data and scheduling appointments. Processing medical only claims as assigned, within requirements set by client service instructions and Gallagher Bassett Best Practices. Work activity includes but is not limited to, review, approval and payment of medical bills and bills from other service...

Gallagher Bassett is the premier provider of global claims services, dedicated to exceptional customer service and demonstrably superior outcomes. GB helps people, teams and businesses overcome adversity and loss through the guiding expertise of over 5,000 claims professionals, all committed to going beyond expectations in the continuous pursuit of a better way. If you're looking for a professional career with an industry leader, that serves an important social purpose, then we invite you to consider becoming an Associate in our Trainee program. We believe in work/life balance and full time here means 35 hours per week. Claims Trainees typically spend 6 - 9 months in training, before beginning a well defined career path with the opportunity for promotion as you meet new performance goals. If you've got the drive to succeed through service we'd love to talk with you. As a Trainee, you will gain skills and experience, via structured learning and on-the-job mentoring: How...

If you are located within the state of California, you will have the flexibility to telecommute* (work from home) as you take on some tough challenges. The health care system is still evolving at a rapid pace. Technology is driving new advances in how patient care is delivered and how it's reimbursed. Now, UnitedHealth Group invites you to help us build a more accurate and precise approach to claims adjudication. In this role, you'll be responsible for the implementation and day to day performance of process activities related to claims research and resolution. This includes the review of claims, contracts, and fee schedules to identify processing, procedural, systemic and billing errors. Join us and build your career with an industry leader. This is a challenging role with serious impact. You'll be providing a senior level of support to a fast paced, intense and high-volume claims operation where accuracy and quality are essential. This position is full - time (40...

Gallagher Bassett is the premier provider of global claims services, dedicated to exceptional customer service and demonstrably superior outcomes. GB helps people, teams and businesses overcome adversity and loss through the guiding expertise of over 5,000 claims professionals, all committed to going beyond expectations in the continuous pursuit of a better way. Position Summary: Administers lower exposure claims in accordance with all pertinent requirements, policies and procedures. Works with and obtains information from clients, claimants, vendors, field personnel and other internal or external resources. Investigates losses to determine cause, scope and extent of damages and/or liability and possible subrogation. Evaluates claim for purposes of setting reserves and making appropriate payments. Documents all activity to support the outcome of the claim file. Achieves fair, equitable and timely claim disposition that is consistent with our customer and internal expectations....

Gallagher Bassett is the premier provider of global claims services, dedicated to exceptional customer service and demonstrably superior outcomes. GB helps people, teams and businesses overcome adversity and loss through the guiding expertise of over 5,000 claims professionals, all committed to going beyond expectations in the continuous pursuit of a better way. Position Summary: Administers lower exposure claims in accordance with all pertinent requirements, policies and procedures. Works with and obtains information from clients, claimants, vendors, field personnel and other internal or external resources. Investigates losses to determine cause, scope and extent of damages and/or liability and possible subrogation. Evaluates claim for purposes of setting reserves and making appropriate payments. Documents all activity to support the outcome of the claim file. Achieves fair, equitable and timely claim disposition that is consistent with our customer and internal expectations....

Gallagher Bassett is the premier provider of global claims services, dedicated to exceptional customer service and demonstrably superior outcomes. GB helps people, teams and businesses overcome adversity and loss through the guiding expertise of over 5,000 claims professionals, all committed to going beyond expectations in the continuous pursuit of a better way. Position Summary: Investigates, evaluates, disposes and settles the most complex claims and highest exposures with minimal supervision. Includes the investigation, determination and evaluation of coverage, liability and damages, and the setting of proper reserves. Incumbents at this level typically hold claims reserve and settlement authority of up to $10,000 liability and/or $25,000 workers compensation or greater. Essential Duties & Responsibilities: Exercises proper judgment and decision making to analyze the claims exposure, to determine the proper course of action and to appropriately settle the...

Gallagher is a global leader in insurance, risk management and consulting services. We help businesses grow, communities thrive and people prosper. We live a culture defined by The Gallagher Way, our set of shared values and guiding tenets. A culture driven by our people, over 30,000 strong, serving our clients with customized solutions that will protect them and fuel their futures. Key Responsibilities: Acts as an advocate for most complex clients and claims, demonstrating advanced problem resolution skills and the ability to manage and communicate issues for key accounts by providing coverage advice to clients. Reviews coverage positions and challenges adjusters as warranted while advocating the best possible outcome for clients in accordance with service standards. Facilitates client meetings, claims reviews and vendor visits. Responsible for negotiating changes in reserves for a positive client outcome, providing status reports to clients as required by any...

Gallagher is a global leader in insurance, risk management and consulting services. We help businesses grow, communities thrive and people prosper. We live a culture defined by The Gallagher Way, our set of shared values and guiding tenets. A culture driven by our people, over 30,000 strong, serving our clients with customized solutions that will protect them and fuel their futures. We are seeking a Client Service Manager to join our growing team. Can you deliver exceptional customer service? Are you interested in helping a range of clients through issues that vary from relatively simple to moderately complex? We are looking for people who are passionate about building relationships with clients, will collaborate with the sales team to achieve goals, constantly seek improvement and will demonstrate the value Gallagher can provide. How will you affect the business? Take a leadership role in the renewal process to ensure the best possible solutions are delivered to...

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing your life's best work.(sm) As a Community Outreach Representative (COR) you'll utilize innovative strategies and programs to ensure access to health care coverage for the underserved and impact millions of lives. You'll use your energetic, empathetic approach to marketing and add value to our team. Through community marketing and outreach efforts, you will have direct impact on membership growth and retention. You'll use your creativity, strategic lens, and outspoken attitude to be part of an elite team to rewrite the history of UnitedHealth Group....

Gallagher Bassett is the premier provider of global claims services, dedicated to exceptional customer service and demonstrably superior outcomes. GB helps people, teams and businesses overcome adversity and loss through the guiding expertise of over 5,000 claims professionals, all committed to going beyond expectations in the continuous pursuit of a better way. Position Summary: Investigates, evaluates, disposes and settles less complex claims with moderate supervision and includes the investigation, determination and evaluation of coverage, liability and damages and the setting of proper reserves. Incumbents at this level typically hold claims reserve and settlement authority of up to $5,000 liability and/or $10,000 workers compensation or greater. Essential Duties & Responsibilities: Exercises proper judgment and decision making to analyze the claims exposure to determine the proper course of action and to appropriately settle the claim. Interacts...

UnitedHealth Group is a company that's on the rise. We're expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn't about another gadget, it's about transforming the health care industry. Ready to make a difference? Make yourself at home with us and start doing your life's best work.(sm) You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: Review medical claims data for accuracy and assist with the resolution of any discrepancies Analyze medical data and interpret key drivers of healthcare trends Conduct studies on healthcare utilization and costs to identify savings opportunities Provide management with actuarially informed findings and conclusions Assist in peer review of analyses completed by actuarial analysts Mentor and supervise actuarial analysts in the technical aspects of the team's projects...

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing your life's best work.(sm) Optum Labs is the research and development arm of UnitedHealth Group. We're a diverse team of curious thinkers and experts in big data, artificial intelligence and machine learning, and scientific and clinical research searching for new ways to help people live healthier lives. We partner with world leaders in health care delivery, research, and technology to create disruptive solutions that serve patients, caregivers, providers, and commercial and government payers. More equitable, effective, and affordable health care -...

Gallagher is a global leader in insurance, risk management and consulting services. We help businesses grow, communities thrive and people prosper. We live a culture defined by The Gallagher Way, our set of shared values and guiding tenets. A culture driven by our people, over 30,000 strong, serving our clients with customized solutions that will protect them and fuel their futures. Position Summary: Responsible for managing all new Pharmacy account activity for Managed Care Services. Key Responsibilities: Communicate and publish schedules associated with all incoming accounts and transfer accounts. Requires professional communication with Sales Staff, Account Managers, Incoming Pharmacy Benefit Management company (PBM), and Outgoing PBM; Includes intense schedule planning and follow up. Requires occasional to frequent travel to meet with high profile accounts during critical implementations. Must possess advanced Microsoft Office skills to utilize technology...

Gallagher Bassett is the premier provider of global claims services, dedicated to exceptional customer service and demonstrably superior outcomes. GB helps people, teams and businesses overcome adversity and loss through the guiding expertise of over 5,000 claims professionals, all committed to going beyond expectations in the continuous pursuit of a better way. Key Responsibilities: Provides medical management to workers compensation injured employees. Performs case management through telephonic contact with all medical providers, employers, claims professionals and ancillary service providers. Manage medical care in order to return injured employee to preinjury status. Reviews services of medical and rehabilitation providers and arranges for and coordinates appropriate evaluation, treatment, and counseling. Communicates with physician, injured worker, employer, referral source, and any other resource involved in worker's rehabilitation program....

Gallagher is a global leader in insurance, risk management and consulting services. We help businesses grow, communities thrive and people prosper. We live a culture defined by The Gallagher Way, our set of shared values and guiding tenets. A culture driven by our people, over 30,000 strong, serving our clients with customized solutions that will protect them and fuel their futures. We are seeking a Client Service Manager to join our growing team. Can you deliver exceptional customer service? Are you interested in helping a range of clients through issues that vary from relatively simple to moderately complex? We are looking for people who are passionate about building relationships with clients, will collaborate with the sales team to achieve goals, constantly seek improvement and will demonstrate the value Gallagher can provide. How will you affect the business? Take a leadership role in the renewal process to ensure the best possible solutions are delivered to...

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing  your life's best work.(sm)  You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.  Primary Responsibilities: Contact providers, hospitals and/or clinical staff via phone and email to explain program and request, set commitments for information return, and explain options for completing and transmitting information Develop and manage on-going relationships with designated providers to reduce provider abrasion, drive program participation and enhance productivity and efficiency Collaborate...

UnitedHealthcare is a company that's on the rise. We're expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn't about another gadget, it's about transforming the health care industry. Ready to make a difference? Make yourself at home with us and start doing your life's best work.(sm) As an Compliance Data Consultant, you’ll review data, look for patterns of potential fraud, waste and/or abuse and interact with the Special Investigations Unit (“SIU”) to complete investigations. You’ll be fully invested in the outcomes and will be helping the health system work better for everyone with the support and resources of a Fortune 5 industry leader.  You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: Establish, mandate and implement standard policies, procedures and best practices regarding UnitedHealthcare Investigations’ claim...