- Point32Health (FL)
- …(https://www.point32health.org/) . **Job Summary** Under the general direction of the Member Appeals and Grievance Supervisor the Appeals and Grievance Analyst ... the professional and compliant management and coordination of assigned member appeals and grievance (complaints) received by Point32Health. This individual works… more
- MyFlorida (Tallahassee, FL)
- 858625-EMPLOYMENT SECURITY REPRESENTATIVE II-LW - 40034208 Date: Aug 15, 2025 The State Personnel System is an E-Verify employer. For more information click on our ... . Requisition No: 858625 Agency: Commerce Working Title: 858625-EMPLOYMENT SECURITY REPRESENTATIVE II-LW - 40034208 Pay Plan: Career Service Position Number:… more
- Cardinal Health (Tallahassee, FL)
- …as assigned in the appropriate system. + Manages and resolves complex insurance claims , including appeals and denials, to ensure timely and accurate ... done. **The Accounts Receivable Specialist II is responsible for processing insurance claims and billing. They will work within the scope of responsibilities as… more
- Banner Health (FL)
- …Health the best place to work and receive care. **The PFS** ** Representative ** **(Ambulatory** **Billing** **)** is responsible for working through the billing ... activities in one or more assigned areas of billing, payment posting, collections, payor claims research, and other accounts receivable work. Works as a member of a… more
- Molina Healthcare (Jacksonville, FL)
- …+ Provides coordination and processing of pharmacy prior authorization requests and/or appeals . + Explains Point of Sale claims adjudication, state, NCQA, ... member and providers with initiating oral and written coverage determinations and appeals . + Records calls accurately in call tracking system. + Maintains specific… more
- CVS Health (Tallahassee, FL)
- …Provide excellent customer services for high volume inbound provider calls for the Claims Inquiry/ Claims Research Medicaid team. Extensive claims research on ... new claim handoffs, nurse reviews, provider complaints, grievance and appeals via target system. + Assists providers with credentialing/re-credentialing and… more
- MyFlorida (Tallahassee, FL)
- …(relocation benefits are not available for this position) OPS Employment Security Representative II This position will be used for multiple vacancies. OPEN ... issues and the chargeability of employer accounts for benefit payments on claims . This may be accomplished telephonically, through written correspondence, or through… more
- MyFlorida (Fort Lauderdale, FL)
- …(relocation benefits are not available for this position) OPS Employment Security Representative II This position will be used for multiple vacancies. OPEN ... issues and the chargeability of employer accounts for benefit payments on claims . This may be accomplished telephonically, through written correspondence, or through… more
- MyFlorida (Orlando, FL)
- …(relocation benefits are not available for this position) OPS Employment Security Representative II This position will be used for multiple vacancies OPEN ... The Work You Will Do: This is an OPS Employment Security Representative II- Employment Review Specialist position in the Department of Commerce's Reemployment… more
- LogixHealth (Dania Beach, FL)
- …follow-up experience in professional healthcare billing + Familiarity with payer regulations, claims appeals processes, and denial reasons + Proficiency in EHR ... of benefits (EOB) statement + Review A/R (Accounts Receivable) reports to follow up on unpaid claims + Prepare and submit out appeals on claims that require… more
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