• Specialist , Appeals & Grievances

    Molina Healthcare (Tampa, FL)
    …to ensure that internal and/or regulatory timelines are met. + Research claims appeals and grievances using support systems to determine appeal and grievance ... outcomes. + Requests and reviews medical records, notes, and/or detailed bills as appropriate; formulates conclusions per protocol and other business partners to… more
    Molina Healthcare (11/07/25)
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  • Charge Capture Specialist - Charge Capture…

    BayCare Health System (Clearwater, FL)
    …excellence. BayCare is currently in search of our newest **Charge Capture Specialist ** who is passionate about providing outstanding customer service to our ... remote role with occasionally coming into the office The **Charge Capture Specialist ** is responsible for: + Responsible for daily charge entry functions, including… more
    BayCare Health System (11/19/25)
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  • Financial Operations Recovery Specialist

    Elevance Health (Tampa, FL)
    …Operations Recovery Specialist ** is responsible for setting up and adjusting claims overpayments that have been previously identified. May do all or some of ... **How you will make an impact:** + Reviews and validates paid claims for overpayments using various techniques including system-based queries, specialized reporting,… more
    Elevance Health (11/20/25)
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  • FEMA - Program Delivery Specialist

    CDM Smith (West Palm Beach, FL)
    …40509BR **Business Unit:** FSU **Job Description:** The Disaster Program Delivery Specialist : * Collects, coordinates and/or reviews applicant data to determine ... expertise may be needed throughout the program delivery process. * Supports the claims process by reviewing and validating damage details, scopes of work, and costs… more
    CDM Smith (10/18/25)
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  • Regulatory Specialist II

    MyFlorida (Tallahassee, FL)
    REGULATORY SPECIALIST II - 79000486 Date: Nov 12, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify Website ... No: 865067 Agency: Business and Professional Regulations Working Title: REGULATORY SPECIALIST II - 79000486 Pay Plan: Career Service Position Number: 79000486… more
    MyFlorida (11/13/25)
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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 &...access + Document and initiate prior authorization process and claims appeals + Report any reimbursement trends or delays… more
    AssistRx (11/02/25)
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  • Social Services Specialist

    City of Jacksonville (Jacksonville, FL)
    Social Services Specialist Print (https://www.governmentjobs.com/careers/jacksonvillefl/jobs/newprint/5152917) Apply  Social Services Specialist Location ... Services Department is actively seeking one (1) Social Services Specialist . Did you know as a City of Jacksonville...preparing family budgets. + Represents clients with respect to claims or applications for benefits, social services, and public… more
    City of Jacksonville (11/26/25)
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  • Meritain Pharmacy Solutions CARE Specialist

    CVS Health (Tallahassee, FL)
    …_Cost Avoidance Research Effort_ ) team. The **Meritain Pharmacy Solutions CARE Specialist ** will engage with patients, helping them to navigate the complexities of ... members and self-funded clients. + Monitors performance of high dollar specialty claims . + Research and outreach on appropriate interchanges of medications from the… more
    CVS Health (11/28/25)
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  • Management Review Specialist - SES

    MyFlorida (Tallahassee, FL)
    MANAGEMENT REVIEW SPECIALIST - SES - 79000454 Date: Nov 24, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify ... No: 865829 Agency: Business and Professional Regulations Working Title: MANAGEMENT REVIEW SPECIALIST - SES - 79000454 Pay Plan: SES Position Number: 79000454 Salary:… more
    MyFlorida (11/26/25)
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  • Regulatory Specialist II - 1

    MyFlorida (Fort Lauderdale, FL)
    REGULATORY SPECIALIST II - 79011329 1 Date: Nov 25, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify Website ... Requisition No: 865965 Agency: Business and Professional Regulations Working Title: REGULATORY SPECIALIST II - 79011329 1 Pay Plan: Career Service Position Number:… more
    MyFlorida (11/26/25)
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