• Certified Coder (Risk Adjustment/Outpatient…

    Molina Healthcare (Orlando, FL)
    …activities with other departments in Molina including Finance, Revenue analytics, Claims and Encounters, and Medical Directors + Maintains professional and technical ... for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare more
    Molina Healthcare (08/21/25)
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  • Director, Enrollment (Duals) - REMOTE

    Molina Healthcare (Orlando, FL)
    …rejections. Address a variety of enrollment questions or concerns received via claims , call tracking, or e-mail. Maintain records in the enrollment database. ... for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare more
    Molina Healthcare (08/08/25)
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  • Manager, Enrollment - REMOTE

    Molina Healthcare (St. Petersburg, FL)
    …rejections. Address a variety of enrollment questions or concerns received via claims , call tracking, or e-mail. Maintain records in the enrollment database. ... for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare more
    Molina Healthcare (08/01/25)
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  • Medical Management Coordinator, RN

    DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
    …as well as knowledge of the interconnection between Utilization Management, claims , and regulatory requirements to respond to complex and/or escalated inquiries. ... + Identifies members who could benefit from care management and refers to the appropriate care manager. + Utilizes critical thinking skills to identify process issues and problems and recommend and/or implement solutions. + May identify workflow and systems… more
    DOCTORS HEALTHCARE PLANS, INC. (08/26/25)
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  • Home Health RN Executive Director of Operations

    Aveanna Healthcare (Miami, FL)
    …regulations * Oversight if internal billing and collection efforts to generate clean claims * Perform other duties as assigned Benefits Offerings: + 401(k) with ... company match + Health, dental, vision, life, and pet insurance + Mileage reimbursement and cell phone allowance + Generous PTO, sick time, and paid holidays + Inclusion Day to celebrate what matters to you + Float Day for extra flexibility and balance + Up to… more
    Aveanna Healthcare (08/21/25)
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  • Government Operations Consultant II

    MyFlorida (Fort Lauderdale, FL)
    … related programs. One (1) year experience auditing or conducting monitoring of medical claims activities related to a healthcare program. Two (2) years of ... that promote transparency and empower consumers in making well informed healthcare decisions. COST-EFFECTIVE Leveraging Florida's buying power in delivering high… more
    MyFlorida (09/03/25)
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  • PBM Senior Reporting Analyst

    CVS Health (Tallahassee, FL)
    …Linux OS, GCP/ AWS/ Azure * Experience working with medical and/or pharmacy claims data * Experience in healthcare industry, including health insurance, PBM ... work with a collaborative, close-knit team on pharmacy and member specific claims data including, but not limited to, financial and operational information… more
    CVS Health (08/30/25)
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  • Aviation Surveyor and Loss Adjuster

    Sedgwick (Miami, FL)
    …Aviation insurance industry. The role will involve handling Hull insurance claims , conducting surveys and meetings internationally, working closely with policy ... holders, insurers, brokers, and service providers to investigate and report on claims , whilst building and maintaining client relationships. As a member of the… more
    Sedgwick (06/20/25)
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  • Inpatient DRG Reviewer

    Zelis (St. Petersburg, FL)
    …So, let's get to it! A Little About Us Zelis is modernizing the healthcare financial experience across payers, providers, and healthcare consumers. We serve more ... top five national health plans, regional health plans, TPAs and millions of healthcare providers and consumers across our platform of solutions. Zelis sees across… more
    Zelis (09/02/25)
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  • DRG Coding Auditor

    Elevance Health (Tampa, FL)
    …is responsible for auditing inpatient medical records and generating high quality recoverable claims for the benefit of the company, for all lines of business, and ... you will make an impact:** + Analyzes and audits claims by integrating medical chart coding principles, clinical guidelines...dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with… more
    Elevance Health (08/13/25)
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