• Lead Director, Pharmacy Appeals

    CVS Health (FL)
    …regulatory updates are operationalized. This role requires a thorough knowledge of claim adjudication, internal MAC & non-MAC related processes, and being a leader ... science, and information technology. + Execute process improvements and system enhancements, including coordinating activates across diverse departments and ensure… more
    CVS Health (01/16/26)
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  • Billing Specialist

    HCA Healthcare (Pensacola, FL)
    …apply now. What you will do in this role: + You will transmit claims to billing vendors, process/ correct insurance rejects, process re-bills, and work unbilled ... and update required information, insurance requirement edits, and follow-up on pending claims + You will attach i-bills or implants invoices to paper billing… more
    HCA Healthcare (11/07/25)
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  • Investigation Specialist II

    MyFlorida (West Palm Beach, FL)
    …Refugee Assistance programs, and have expertise in the use of the Florida computer system and other on-line systems . The person occupying this position works to ... - 60025069 Date: Jan 16, 2026 The State Personnel System is an E-Verify employer. For more information click...THE FOLLOWING: + Experience working with State Attorney overpayment claims + Experience with problem-solving techniques within a work… more
    MyFlorida (01/17/26)
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  • Field Service Power Generation Technician

    Cummins Inc. (Tampa, FL)
    …and tools. - Completing required documentation, such as service worksheets, timesheets, warranty claims via handwritten forms or business system input screens. - ... claims , quality documents via handwritten forms or business system input screens. Completes training in line with skill...has been resolved; documents results of troubleshooting in business systems to communicate what has been done for payment… more
    Cummins Inc. (11/18/25)
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  • Reimbursement Technical Analyst

    Cognizant (Tallahassee, FL)
    …closely with configuration analysts and other operational stakeholders to maintain and improve claims reimbursement systems . **In this role, you will:** + Review ... standards (CPT, CCI, CMS). + Manage and update the Claims Reimbursement database to ensure edit rules and tables...with CPT, CCI, CMS, or health plan-specific rules for claim payment. + Knowledge of health plan/provider contracting and… more
    Cognizant (01/08/26)
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  • Senior Product Manager

    Humana (Tallahassee, FL)
    …outcomes. **Key Responsibilities:** + Lead large-scale product efforts focused on improving claims processing and related systems , ensuring these efforts support ... with provider networks and external partners impacted by changes in claims adjudication systems **Use your skills to make an impact** **Required Qualifications**… more
    Humana (01/13/26)
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  • Medical Collector (H)

    University of Miami (Medley, FL)
    …workers' compensation (WC), bankruptcy-related cases, probate accounts requiring Statements of Claim , and billing dispute accounts. + Process subpoenas and 766 ... via outbound calls, inbound calls, and email to resolve account and claim issues. + Negotiate settlements in accordance with organizational policy. + Monitor… more
    University of Miami (01/17/26)
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  • Senior Fire Investigator, Iaai-CFI

    EFI Global (Miami, FL)
    …manner; documents all relevant facts pertaining to files in the appropriate claims handling system (s) and keeps management informed of developments that ... buildings or residences.** **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** **Investigates assigned claims suspected of insurance fraud, this includes large loss, large… more
    EFI Global (11/25/25)
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  • Lead, Accounts Receivable Specialist

    Cardinal Health (Doral, FL)
    …group purchasing contracts. + Demonstrates knowledge of financial processes, systems , controls, and work streams. + Demonstrates experience working collaboratively ... appropriate. + Acts as a subject matter expert in claims processing. + Processes claims : investigates insurance...+ Manages billing queue as assigned in the appropriate system . + Investigates and updates the system … more
    Cardinal Health (12/04/25)
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  • Branch Coordinator, Home Health

    CenterWell (Tampa, FL)
    …Also, responsible for day-to-day coordination of telephone / personnel communication systems , overall management of agency supplies / mail, and processing of ... computer programs as appropriate. + Complete End of Period claim workflow as part of Billing Specialist responsibilities. This...to ensure other billing requirements are satisfied to release claims timely. + Adhere to and participate in Agency's… more
    CenterWell (01/06/26)
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