- 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
- Cognizant (Tallahassee, FL)
- …. Maintain working knowledge of applicable health insurers' internal claims, appeals , and retro-authorization as well as timely filing deadlines and processes. ... Medicare, Medicaid, and third-party guidelines. . Effectively document and log claims/ appeals information on relevant tracking systems . Utilize critical thinking… more
- Molina Healthcare (Orlando, FL)
- …DESCRIPTION** **Job Summary** Responsible for reviewing and resolving Medicare member appeals and Medicare claims in communicating resolution to members and provider ... + Responsible for the comprehensive research and resolution of the appeals from Molina members, providers and related outside agencies to ensure… more
- Molina Healthcare (Jacksonville, FL)
- …+ Responsible for the comprehensive research and resolution of the appeals , dispute, grievances, and/or complaints from Molina members, providers and related ... ensure that internal and/or regulatory timelines are met. + Research claims appeals and grievances using support systems to determine appeal and grievance outcomes.… 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
- BayCare Health System (Clearwater, FL)
- …documentation, and medical records. + Triage, plan, and execute intake of Appeals and Grievance submissions. + Keeping track of deadlines, ensuring all necessary ... management. + Identify trends or recurring issues in member grievances and appeals and recommend process improvements to prevent future occurrences. + Participate in… more
- AssistRx (Orlando, FL)
- …provided for a specific pharmaceutical product. The Insurance Verification Specialist will support the healthcare providers addressing questions regarding coding ... (PA) for an assigned caseload and helps navigate the appeals process to access medications. + Ensure cases move...+ Document and initiate prior authorization process and claims appeals + Report any reimbursement trends or delays in… more
- AssistRx (Maitland, FL)
- …coverage provided for a specific pharmaceutical product. The Patient Access Specialist will support the healthcare providers addressing questions regarding coding ... (PA) for an assigned caseload and helps navigate the appeals process to access medications. + Ensure cases move...+ Document and initiate prior authorization process and claims appeals + Report any reimbursement trends or delays in… more
- LogixHealth (Dania Beach, FL)
- Location: On-Site in Dania Beach, FL This Role: As a Billing Specialist at LogixHealth, you will work with a team of fellow medical billers, administrators, and ... to follow up on unpaid claims + Send out appeals on claims that require an appeal + Submit...professional healthcare billing + Familiarity with payer regulations, claims appeals processes, and denial reasons + Proficiency in EHR… more
- AssistRx (Orlando, FL)
- …provided for a specific pharmaceutical product. The Insurance Verification Specialist will support the healthcare providers addressing questions regarding coding ... (PA) for an assigned caseload and helps navigate the appeals process to access medications. + Ensure cases move...+ Document and initiate prior authorization process and claims appeals + Report any reimbursement trends or delays in… more