• 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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  • 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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  • Associate Specialist, Appeals & Grievances…

    Molina Healthcare (Doral, FL)
    …by the Centers for Medicare and Medicaid. **KNOWLEDGE/SKILLS/ABILITIES** + Enters denials and requests for appeal into information system and prepares documentation ... systems and other available resources. + Assures timeliness and appropriateness of appeals according to state and federal and Molina Healthcare guidelines. +… more
    Molina Healthcare (08/09/25)
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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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  • Physician - Physician Advisor

    Ascension Health (Jacksonville, FL)
    …improvement, coding, quality and/or compliance processes. + Develop strategy and processes to reduce denials and audits. + Assist with appeals and length of stay ... market initiatives. + Utilize hospital data sources to identify & analyze patterns of over or under-utilization of services, quality metrics and collaborate with appropriate stakeholders to help achieve those goals. **About Ascension St. Vincent's Hospitals… more
    Ascension Health (05/14/25)
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  • Medical Biller/Collections Specialist

    Robert Half Accountemps (Melbourne, FL)
    …outstanding insurance claims by utilizing online portals and other resources. * Handle appeals related to payment denials or underpayments, ensuring timely and ... receivable processes. * Strong knowledge of medical billing functions, including appeals and authorizations. * Experience working with diagnosis codes, payer… more
    Robert Half Accountemps (08/01/25)
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