• RN Medical Claim Review Nurse Remote

    Molina Healthcare (Jacksonville, FL)
    …appeal has been submitted, to ensure medical necessity and appropriate/accurate billing and claims processing . * Validates member medical records and claims ... for medical claim review activities. Responsible for ensuring timely claims payment processes, providing counsel to members regarding coverage...federal regulations based on specific state and line of business . Must be able to work in a fast… more
    Molina Healthcare (10/19/25)
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  • Eligibility Supervisor - SES

    MyFlorida (Fort Myers, FL)
    …interviews, providing counseling, recruiting, billing, or collecting accounts, checking credit, processing insurance policies or claims or providing customer ... Date: 10/23/2025 Total Compensation Estimator Tool (https://compcalculator.myflorida.com/) Economic Self-Sufficiency Specialist Supervisor - SES This is an Internal Agency… more
    MyFlorida (10/10/25)
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  • Investigator, Coding Special Investigative Unit…

    Molina Healthcare (Jacksonville, FL)
    …**Preferred Experience** + 2+ years of experience working in the group health business preferred, particularly within claims processing or operations. + ... + Experience with UNET, Comet, Macess/CSP, or other similar claims processing systems. + Demonstrated ability to...+ AAPC Certified Medical CPC, CPMA, CPCO or similar specialist preferred + Certified Fraud Examiner and/or AHFI professional… more
    Molina Healthcare (10/22/25)
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  • Lead Data Scientist - Research and Development…

    Highmark Health (Tallahassee, FL)
    …regression models, tree-based learning, neural networks, clustering techniques, natural language processing ) + Consult with the business to contextualize and ... work will directly impact millions of lives. As our Lead Graph Intelligence specialist , you will be the spearhead of cutting-edge research projects. This means… more
    Highmark Health (08/29/25)
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  • Eligibility Supervisor - SES

    MyFlorida (Tampa, FL)
    …interviews, providing counseling, recruiting, billing, or collecting accounts, checking credit, processing insurance policies or claims or providing customer ... orally and in writing + Ability to apply ethical business practices MINIMUM REQUIREMENTS + Two years or more...the experience. + Plus minimum of two years of processing experience in the Economic Self-Sufficiency Program as an… more
    MyFlorida (10/08/25)
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  • Loss Mitigation Spec II

    TD Bank (Jacksonville, FL)
    …to resolve delinquency and avoid default or adverse action + Assists Customers in processing insurance claims and requests for contractual rebates + May initiate ... skills and experience, job-related knowledge, geographic location, and other specific business and organizational needs. As a candidate, you are encouraged to… more
    TD Bank (10/22/25)
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  • Accounts Receivable

    Mass Markets (FL)
    …Professional Staffing (TAPS Schedule 736), Business Process Management (BPM), Business Process Outsourcing (BPO), Claims Processing , Collections, ... POSITION OVERVIEW MCI is one of the fastest-growing tech-enabled business services companies in the USA, with a strong call center footprint and operations that… more
    Mass Markets (10/08/25)
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  • Medical Billing /Payroll _ Home Care

    BrightStar Care (Naples, FL)
    …. We are looking for the an experienced medical Billing and Payroll Specialist . Responsibilities include weekly processing of billing and payroll.. Managing ... Home care agency, is a locally owned and operated business that has been serving Lee and Collier counties...Authorizations , appeals and re- submission of claims . Posting cash etc. Must be detail oriented… more
    BrightStar Care (08/28/25)
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  • Specialty Pharmacy Liaison - Earn up to 1500.00…

    AssistRx (Orlando, FL)
    …with medication assistance, prior authorizations, pharmacy benefits investigation, managed care, claims processing . + Experience working with pharmaceutical or ... Pharmacies + Relays status updates and challenges to Program Specialist as appropriate + Provide support as needed in...biotech companies. + 5 years of progressive health care business experience (SPP, hospitals, or insurance). + Computer skills… more
    AssistRx (09/05/25)
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  • Eligibility Supervisor - SES - 1

    MyFlorida (Orlando, FL)
    …interviews, providing counseling, recruiting, billing, or collecting accounts, checking credit, processing insurance policies or claims or providing customer ... the experience. + Plus minimum of two years of processing experience in the Economic Self-Sufficiency Program as an...in the Economic Self-Sufficiency Program as an Economic Self-Sufficiency Specialist II. The following examples of work and the… more
    MyFlorida (10/23/25)
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