• Registered Nurse or Physical Therapist…

    CenterWell (Tallahassee, FL)
    …responding to, managing and monitoring all payer requests for additional documentation (ADR), appeals and denials . Works with branch staff to gather required ... to develop appropriate and timely responses. + Responsible for constructing response to denials and appeals , utilizing any federal guidelines or local coverage… more
    CenterWell (07/30/25)
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  • Specialist, Appeals & Grievances (Medicare…

    Molina Healthcare (FL)
    …subrogation, and eligibility criteria. + Familiarity with Medicaid and Medicare claims denials and appeals processing, and knowledge of regulatory guidelines for ... able to rotate weekends and holidays** Must have Medicare Appeals and IRE experience** **Job Summary** Responsible for reviewing... appeals and denials . + Strong verbal and written communication skills +… more
    Molina Healthcare (06/26/25)
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  • Specialist, Appeals & Grievances

    Molina Healthcare (Orlando, FL)
    …subrogation, and eligibility criteria. + Familiarity with Medicaid and Medicare claims denials and appeals processing, and knowledge of regulatory guidelines for ... to ensure that internal and/or regulatory timelines are met. + Research claims appeals and grievances using support systems to determine Provider No Surprises Act… more
    Molina Healthcare (08/01/25)
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  • Inpatient Coding Denials Specialist

    HCA Healthcare (Orange Park, FL)
    …Inpatient Coding Denials Specialist must ensure timely, accurate, and thorough appeals for all accounts assigned and apply critical thinking skills to ascertain ... organization that invests in you as an Inpatient Coding Denials Specialist? At Parallon, you come first. HCA Healthcare...difference. We are looking for a dedicated Inpatient Coding Denials Specialist like you to be a part of… more
    HCA Healthcare (07/26/25)
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  • Chief Medical Officer

    HCA Healthcare (Gainesville, FL)
    …pricing, and analysis of managed care issues. Offers clinical support for appeals and denials process, discharge planning, case management, and utilization ... case managers and hospital staff in the reduction of payer denials and in the denial and appeals process, as requested by the Case Management Department and… more
    HCA Healthcare (08/03/25)
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  • Representative II, Accounts Receivable

    Cardinal Health (Tallahassee, FL)
    …in the appropriate system. + Manages and resolves complex insurance claims, including appeals and denials , to ensure timely and accurate reimbursement. + ... Processes denials & rejections for re-submission (billing) in accordance with...changes that may need to be made. + Processes denials & rejections for re-submission (billing) in accordance with… more
    Cardinal Health (07/24/25)
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  • Patient Access Insurance Authorization Specialist

    Intermountain Health (Tallahassee, FL)
    …all pertinent patient related insurance eligibility, benefits, authorization; follow-up on appeals and denials when requested + Contacts patient/provider when ... insurance eligibility, securing prior authorization and managing authorization related denials to ensure patient financial health. **Essential Functions** +… more
    Intermountain Health (08/08/25)
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  • Physician Advisor

    AdventHealth (Orlando, FL)
    …on documentation. Assist in billing for technical component of services and appeals for denials . Provides guidance to clinical questions from Utilization ... Management staff involved in authorizations, concurrent review, and denials as a back up to UM Physician Advisory as and when needed. Assists with interpretation of… more
    AdventHealth (08/07/25)
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  • Patient Navigator

    Akumin (West Palm Beach, FL)
    …imaging procedures from insurance companies. Provides supporting documentation for all insurance appeals and denials . + Other duties as assigned. **Position ... Requirements:** + High School Diploma or equivalent experience. + CPR Certification. + 1 year in medical/hospital setting + **Interpersonal Skills:** Relationship building skills to work with all functional units of the organization effectively. Experience in… more
    Akumin (08/08/25)
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  • Fiscal Assistant I

    MyFlorida (Bunnell, FL)
    …medical or dental claims. Knowledge of working medical or dental claims for appeals and denials . Florida Department of Health Mission, Vision, and Values: ... Mission: To protect, promote & improve the health of all people in Florida through integrated state, county & community efforts. Vision: To be the Healthiest State in the Nation. Values: I nnovation: We search for creative solutions and manage resources… more
    MyFlorida (07/31/25)
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