- Lincoln Financial (Tallahassee, FL)
- …for this opportunity. **Requisition #:** 74565 **The Role at a Glance** As an Appeals Specialist you will be responsible for being a product subject matter ... for multiple product lines. You will perform and deliver on appeals claims assignments/projects while simultaneously leveraging and applying knowledge. You will… more
- Molina Healthcare (FL)
- …hours** Must be able to rotate weekends and holidays** Must have Medicare Appeals and IRE experience** **Job Summary** Responsible for reviewing and resolving member ... appeals and communicating resolution to members and provider (or...Responsible for the comprehensive research and resolution of the appeals , dispute, grievances, and/or complaints from Molina members, providers… more
- Molina Healthcare (Orlando, FL)
- …to ensure that internal and/or regulatory timelines are met. + Research claims appeals and grievances using support systems to determine Provider No Surprises Act ... + Min. 2 years operational managed care experience (call center, appeals or claims environment). + Health claims processing background, including coordination… more
- Robert Half Office Team (Miramar, FL)
- Description We are looking for a dedicated Customer Service Representative/Prior Authorizations/Clinical Appeals Specialist to join our team in Miramar, Florida. ... This contract position offers an exciting opportunity to provide outstanding support to customers through various communication channels, ensuring their needs are met efficiently and professionally. If you have a passion for delivering excellent service and… more
- Molina Healthcare (Tampa, FL)
- …request authorization. Strongly prefer candidates with a background in appeals and grievances. Excellent computer multi-tasking skills and good productivity ... office with internet connectivity of high speed required **Job Summary** Clinical Appeals is responsible for making appropriate and correct clinical decisions for … more
- MyFlorida (Tallahassee, FL)
- BENEFITS SPECIALIST - 72002680 Date: Jul 31, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify Website ... . Requisition No: 856038 Agency: Management Services Working Title: BENEFITS SPECIALIST - 72002680 Pay Plan: Career Service Position Number: 72002680 Salary:… more
- CenterWell (Tallahassee, FL)
- …caring community and help us put health first** The **Denials Management Specialist ** is responsible to respond to, monitor and analyze all governmental requests, ... to, managing and monitoring all payer requests for additional documentation (ADR), appeals and denials. Works with branch staff to gather required information and… more
- AssistRx (Orlando, FL)
- …referral bonus! A Day in the Life as a Bilingual Patient Access Specialist : This role works directly with healthcare providers & insurance plans/payers to gather ... provided for a specific pharmaceutical product. The Bilingual Patient Access Specialist will support the healthcare providers addressing questions regarding coding… more
- HCA Healthcare (Orange Park, FL)
- …local, state and federal agencies and accrediting bodies. The Inpatient Coding Denials Specialist must ensure timely, accurate, and thorough appeals for all ... that invests in you as an Inpatient Coding Denials Specialist ? At Parallon, you come first. HCA Healthcare has...We are looking for a dedicated Inpatient Coding Denials Specialist like you to be a part of our… more
- Molina Healthcare (Orlando, FL)
- …Member issues in areas involving member impact and engagement including: Appeals and Grievances, Member Problem Research and Resolution, and the ... analyses of advocacy issues; and assists with documentation preparation for appeals , fair hearings or other formal/informal dispute resolution process. * Provides… more