• Appeals Specialist - Fully Remote

    TEKsystems (Jacksonville, FL)
    …this is not the simple call - this is a follow up that's been re-routed to the appeals specialist to do in the depth review of the denial letter to determine the ... revenue cycle appeal, revenue cycle specialist , denials specialist , appeals specialist , insurance follow...follow up, root cause analysis, EHR, EMR, EPIC, Cerner, medical billing, claims audit, appeals process, … more
    TEKsystems (09/05/25)
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  • Appeals & Grievance Specialist…

    Cognizant (Tallahassee, FL)
    ** Appeals & Grievance Specialist (remote)** This is a remote position open to any qualified applicant in the United States. **Job Summary:** We are seeking a ... dedicated Appeals & Grievance Specialist with 2 to...or Grievance is legitimate. A strong understanding of Claims, Appeals and Medical Benefits. Referring suspicious or… more
    Cognizant (09/04/25)
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  • Specialist , Appeals & Grievances…

    Molina Healthcare (Miami, FL)
    …hours** Must be able to rotate weekends and holidays** Must have Medicare Appeals and IRE experience** Responsible for reviewing and resolving member and provider ... + Responsible for the comprehensive research and resolution of the appeals , dispute, grievances, and/or complaints from Molina members, providers and related… more
    Molina Healthcare (08/21/25)
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  • Associate Specialist , Appeals…

    Molina Healthcare (FL)
    …for letters and prepare responses to appeals and grievances. + Elevates appropriate appeals to the Appeals Specialist . + Generates and mails denial ... systems and other available resources. + Assures timeliness and appropriateness of appeals according to state and federal and Molina Healthcare guidelines. +… more
    Molina Healthcare (08/30/25)
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  • Clinical Appeals Nurse (RN)

    Molina Healthcare (Tampa, FL)
    …appeals outcomes within compliance standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse (RN) performs clinical/ medical reviews of previously ... + Serves as a clinical resource for Utilization Management, Chief Medical Officer, Physicians, and Member/Provider Inquiries/ Appeals . + Provides training,… more
    Molina Healthcare (08/15/25)
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  • ED Medical Billing Specialist

    LogixHealth (Dania Beach, FL)
    Location: On-Site in Dania Beach, FL This Role: As a Billing Specialist at LogixHealth, you will work with a team of fellow medical billers, administrators, and ... to follow up on unpaid claims + Send out appeals on claims that require an appeal + Submit...professional healthcare billing + Familiarity with payer regulations, claims appeals processes, and denial reasons + Proficiency in EHR… more
    LogixHealth (08/08/25)
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  • Bilingual Patient Access Specialist…

    AssistRx (Orlando, FL)
    …Patient Access Specialist : + In-depth understanding and experience with Major Medical & Pharmacy Benefit Coverage + 2 to 3 years of benefit investigation ... Day in the Life as a Bilingual Patient Access Specialist : This role works directly with healthcare providers &...(PA) for an assigned caseload and helps navigate the appeals process to access medications. + Ensure cases move… more
    AssistRx (08/03/25)
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  • Inpatient Coding Denials Specialist

    HCA Healthcare (Orange Park, FL)
    …local, state and federal agencies and accrediting bodies. The Inpatient Coding Denials Specialist must ensure timely, accurate, and thorough appeals for all ... that invests in you as an Inpatient Coding Denials Specialist ? At Parallon, you come first. HCA Healthcare has...colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no… more
    HCA Healthcare (07/26/25)
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  • Insurance Verification Specialist - Earn…

    AssistRx (Orlando, FL)
    …provided for a specific pharmaceutical product. The Insurance Verification Specialist will support the healthcare providers addressing questions regarding coding ... (PA) for an assigned caseload and helps navigate the appeals process to access medications. + Ensure cases move...In-depth understanding and experience with Buy & Bill, Major Medical & Pharmacy Benefit Coverage. + 2 to 5… more
    AssistRx (09/05/25)
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  • Patient Access Specialist - Specialty…

    AssistRx (Maitland, FL)
    …coverage provided for a specific pharmaceutical product. The Patient Access Specialist will support the healthcare providers addressing questions regarding coding ... (PA) for an assigned caseload and helps navigate the appeals process to access medications. + Ensure cases move...patients Requirements + In-depth understanding and experience with Major Medical & Pharmacy Benefit Coverage + 2 to 3… more
    AssistRx (08/27/25)
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