• Bilingual Call Center Representative (Fluent…

    Mass Markets (Tampa, FL)
    …736), Business Process Management (BPM), Business Process Outsourcing (BPO), Claims Processing , Collections, Customer Experience Provider (CXP), Customer ... support inbound customer service, help desk, technical support, and back-office processing representatives for commercial and public sector support positions. In… more
    Mass Markets (10/14/25)
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  • Senior Triage Examiner

    ICW Group (Orlando, FL)
    …injured workers. + Communicates with insureds to obtain information necessary for processing claims . + Contacts and/or interviews injured workers, doctors, ... and employers to get additional information. + Communicates claim activity and processing with the injured worker and insured. + Maintains professional client… more
    ICW Group (12/02/25)
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  • Special Investigations Unit (SIU) Investigator…

    Prime Therapeutics (Tallahassee, FL)
    …compelling communications + Knowledge and understanding of pharmacy and medical claims processing environment **Preferred Qualifications** + Certified Fraud ... and/or prescriber fraud, waste and abuse (FWA). This position conducts claims data mining, fraud analysis and auditing/monitoring activities and proactively… more
    Prime Therapeutics (12/05/25)
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  • Claim Field Analyst (Tampa, Florida)

    CVS Health (Tallahassee, FL)
    …+ 3+ years of experience in medical billing and coding, specifically related to claims processing and root cause analysis. + 3+ years of experience with ... assist in creating bulletins, newsletters, and claim trainings to improve provider claims issues. as well as billing practices, while collaborating with internal… more
    CVS Health (12/03/25)
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  • Manager, Medical Economics (New York Health Plan)

    Molina Healthcare (Tampa, FL)
    …of healthcare operations (utilization management, disease management, HEDIS quality measures, claims processing , etc.) + Knowledge of healthcare financial terms ... executive decision-making + Mine and manage information from large data sources. + Analyze claims and other data sources to identify early signs of trends or other… more
    Molina Healthcare (11/21/25)
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  • Principal, Stars Enterprise Activation - Insurance…

    Humana (Tallahassee, FL)
    …Operations encompasses critical functions including care coordination, quality measurement, billing, claims processing , and customer service, each essential to ... operational knowledge of core functional areas (care coordination, quality, billing, claims , and customer service). + Collaborate with each Insurance Operations… more
    Humana (11/19/25)
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  • Housing Specialist

    Sedgwick (Tampa, FL)
    …college or university preferred. **Experience** Four (4) years of experience in claims processing or related business experience, or equivalent combination of ... for this or other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The… more
    Sedgwick (11/14/25)
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  • Information Resource Manager II

    MyFlorida (Tallahassee, FL)
    …computing with emphasis in data processing , financial accounting, draw games, claims processing and prize payment, and website. + Knowledge of concepts, ... on bids. + Assists in the establishment of information processing standards for the Florida Lottery. + Assists in...the latest technology, trends, and developments in the data processing industry as they relate to the Florida Lottery's… more
    MyFlorida (12/05/25)
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  • Provider Appeals & Grievances Specialist (remote)

    Cognizant (Tallahassee, FL)
    …policies. **Basic qualifications:** 2 years of Appeals and Grievance 1 Year of medical claims processing experience (Must be with a healthcare plan, not on ... of provider or provider's office) Medicaid & Medicare insurance customer service or claims processing 2 Years of medical health insurance (Must be with a managed… more
    Cognizant (12/10/25)
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  • Billing Specialist

    Community Health Systems (Crestview, FL)
    …standards. **Qualifications** + 0-2 years of experience in medical billing, insurance claims processing , or revenue cycle management required **Knowledge, Skills ... Summary** The Billing Specialist I is responsible for performing insurance claim processing , billing, and follow-up to ensure timely and accurate reimbursement. This… more
    Community Health Systems (12/10/25)
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