• Director, Appeals & Grievances (Medicare…

    Molina Healthcare (Jacksonville, FL)
    …and directing the activities of the Medicare Contracted Provider Post-Pay Claim Appeals and Disputes in accordance with the standards and requirements established by ... the activities of the Medicare Contracted Provider Post-Pay Claim Appeals and Disputes that is responsible for reviewing and... and grievance processing/resolution, including 2 years in a manager role. * Experience reviewing all types of medical… more
    Molina Healthcare (07/18/25)
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  • Grievance/ Appeals Analyst I

    Elevance Health (Miami, FL)
    **Title: Grievance/ Appeals Analyst I** **Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person training ... an accommodation is granted as required by law._ The **Grievance/ Appeals Analyst I** is an entry level position in...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
    Elevance Health (08/14/25)
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  • Clinical Appeals Nurse (RN)

    Molina Healthcare (Tampa, FL)
    **JOB DESCRIPTION** **Job Summary** Clinical Appeals is responsible for making appropriate and correct clinical decisions for appeals outcomes within compliance ... standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse (RN) performs clinical/medical reviews of previously denied cases in which a formal appeals more
    Molina Healthcare (08/15/25)
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  • Medical Director-Internal Medicine or Family…

    Elevance Health (Miami, FL)
    **Medical Director-Internal Medicine or Family Medicine Appeals ** **Location:** This role enables associates to work virtually full-time, with the exception of ... by law. The **Medical Director-Internal Medicine or Family Medicine Appeals ** is responsible for the review of appeals...and quality. + Work independently with oversight from immediate manager . + May be responsible for an entire clinical… more
    Elevance Health (08/21/25)
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  • Deputy Building Official

    City of Coral Gables, FL (Coral Gables, FL)
    …by the State of Florida and the Miami-Dade County Board of Rules and Appeals as a Certified Building Official and licensed as a Certified Floodplain Manager ... training course approved by the Board of Rules and Appeals before certification; or (2)Possess a current Registered Architect...Certified Building Official and licensed as a Certified Floodplain Manager (CFM)? + Yes + No 02 Do you… more
    City of Coral Gables, FL (08/22/25)
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  • Field Reimbursement Manager

    Adecco US, Inc. (Orlando, FL)
    …currently assisting one of its clients in their search for a Field Reimbursement Manager to work remotely from Florida! **Pay rate** : $51.95 - 60.10 **Shift ... on Apply Now and don't forget to upload your resume!** The Field Reimbursement Manager (FRM) plays a critical role in facilitating patient access to therapy by… more
    Adecco US, Inc. (08/21/25)
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  • Field Reimbursement Manager (Immunology…

    J&J Family of Companies (Jacksonville, FL)
    …Florida, United States of America **Job Description:** **Field Reimbursement Manager (Immunology Dermatology)- Jacksonville, FL- Johnson & Johnson HCS, Inc** ... and Customer Solutions (PECS) team is recruiting for a Field Reimbursement Manager which will be a field-based position that will include the Jacksonville,… more
    J&J Family of Companies (08/25/25)
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  • Field Reimbursement Manager (Immunology…

    J&J Family of Companies (Pensacola, FL)
    …States, Tallahassee, Florida, United States **Job Description:** **Field Reimbursement Manager (Immunology Rheumatology)- (Pensacola, FL) - Johnson & Johnson HCS, ... and Customer Solutions (PECS) team is recruiting for a Field Reimbursement Manager which will be a field-based position that will include Pensacola, Tallahassee,… more
    J&J Family of Companies (08/25/25)
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  • Manager , Medicare Administration

    Molina Healthcare (Miami, FL)
    …regarding compliance with local, state and federal guidelines. * Establishes member grievance appeals and policies and updates annually or as directed by the Centers ... for Medicare and Medicaid Services. * Establishes non-contracted provider dispute and appeals policies and policies and updates annually or as directed by the Center… more
    Molina Healthcare (08/24/25)
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  • Claims Manager

    CHS (Clearwater, FL)
    **Overview** **Claims Manager ** **Servicing** **Health Insurance Policies or Benefits** **Summary:** Premier Administrative Solutions (PAS) is a Third-Party ... the client's stated coverage. Join Premier Administrative Solutions as a Claims Manager and lead our Claims Department in delivering exceptional service to insurance… more
    CHS (08/08/25)
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