• Medical Director - Claims Management

    Humana (Tallahassee, FL)
    **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to make ... well as a focus on collaborative business relationships, value-based care, population health , or disease or care management. Medical Directors support Humana values… more
    Humana (10/16/25)
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  • Account Consultant- Remote Opportunity-…

    Sedgwick (Jacksonville, FL)
    …Fortune Best Workplaces in Financial Services & Insurance Account Consultant- Remote Opportunity- Flood Experience Required **PRIMARY PURPOSE** **:** To manage claim ... caseload of basic to highly complex claims within granted authority level including related financial implications, along with financial implications and to mentor… more
    Sedgwick (08/21/25)
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  • Divisional Coder III Remote

    AdventHealth (Altamonte Springs, FL)
    …Day One . Career Development . Whole Person Wellbeing Resources . Mental Health Resources and Support **Our promise to you:** Joining AdventHealth is about being ... understanding that together we are even better. **Job Location: Monday-Friday - Remote ** **The role you'll contribute:** Assigns codes to hospital inpatient accounts… more
    AdventHealth (08/07/25)
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  • Associate Manager RN Denials Management

    Banner Health (FL)
    …with State Pay Transparency Rules. Innovation and highly trained staff. Banner Health recently earned Great Place To Work(R) Certification (TM) . This recognition ... Find out how we're constantly improving to make Banner Health the best place to work and receive care....A typical day would include overseeing RN denials mgt specialists and Audit team, posting bill reviews, and managing… more
    Banner Health (10/16/25)
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  • Medical Claim Review Nurse (RN)

    Molina Healthcare (Tampa, FL)
    …Looking for a RN that has a current active unrestricted license This a remote role and can sit anywhere within the United States. Work Schedule Monday to ... work on set schedule) Looking for a RN with experience with appeals, claims review, and medical coding. **Job Summary** Utilizing clinical knowledge and experience,… more
    Molina Healthcare (09/06/25)
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  • Inpatient Coding Auditor

    BayCare Health System (Tampa, FL)
    …largest employers within the Tampa Bay area. **Position Details:** + **Location:** Fully Remote (must reside in the state of Florida, Georgia, South Carolina, or ... Monday - Friday The **Inpatient** **Coding Auditor** is a full-time remote position. _Sign on bonuses available!_ **Responsibilities** + The Inpatient Coding… more
    BayCare Health System (10/10/25)
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  • Medical Bill Navigator

    Zelis (St. Petersburg, FL)
    …consumers. We serve more than 750 payers, including the top five national health plans, regional health plans, TPAs and millions of healthcare providers ... who you are. Position Overview The Medical Bill Navigator, Health Bill Assist will be responsible for delivering high-touch,...financial outcomes. What you will do: + Analyze medical claims submitted by members along with their Explanation of… more
    Zelis (09/22/25)
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  • Consultant, Nurse Disability I

    Lincoln Financial (Tallahassee, FL)
    **Alternate Locations:** Work from Home **Work Arrangement:** Remote : Work at home employee residing outside of a commutable distance to an office location. ... be responsible for reviewing, analyzing, and interpreting medical information available for disability claims . In this role you will act as a clinical resource for… more
    Lincoln Financial (10/10/25)
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  • Pediatric & Family Medicine Medical Director…

    Centene Corporation (Tallahassee, FL)
    …implementation of recommendations to providers that would improve utilization and health care quality. + Reviews claims involving complex, controversial, ... 28 million members as a clinical professional on our Medical Management/ Health Services team. Centene is a diversified, national organization offering competitive… more
    Centene Corporation (10/08/25)
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  • Medical Director - Medicare Grievances and Appeals…

    Humana (Tallahassee, FL)
    … first** The Corporate Medical Director relies on medical background and reviews health claims and preservice appeals. The Corporate Medical Director works on ... Qualifications** + Medical utilization management experience, + working with health insurance organizations, hospitals and other healthcare providers, patient… more
    Humana (10/02/25)
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