• Customer Solutions and Claims Specialist

    Nestle (Palm Beach Gardens, FL)
    …and nutrition for patients and consumers. **POSITION OVERVIEW:** The Customer Solutions and Claims Specialist serves as the primary point of contact for the customer ... Identify and resolve demand capture failures to ensure timely processing . + Monitor and address account specific issues upon...and pivot tables. **This position will be either a remote or hybrid role based on the selected candidate's… more
    Nestle (07/22/25)
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  • Lead Analyst, Configuration Oversight - Payment…

    Molina Healthcare (St. Petersburg, FL)
    …Lead Analyst, Configuration Oversight to support our Payment Integrity and Claims Operations teams in ensuring the accuracy and compliance of Coordination ... of Benefits (COB) claim pricing and processing . This role will focus on identifying, reviewing, and...guidance. The ideal candidate will bring deep knowledge of claims adjudication, QNXT system navigation, and strong analytical acumen.… more
    Molina Healthcare (07/24/25)
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  • Experienced Desk Adjuster - Remote

    Sedgwick (Tallahassee, FL)
    …Fortune Best Workplaces in Financial Services & Insurance Experienced Desk Adjuster - Remote **PRIMARY PURPOSE** **:** Handles losses and claims valued up to ... Efficiently manages a case load using technology for efficient claim processing . **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Evaluates insurance policies, … more
    Sedgwick (07/11/25)
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  • Prior Authorization Technician - Remote

    Polaris Pharmacy Services, LLC (Fort Lauderdale, FL)
    Prior Authorization Technician - Remote Job Details Job Location Polaris Pharmacy Services of Ft Lauderdale - Ft. Lauderdale, FL Remote Type Fully Remote ... Position Type Full Time Job Category Pharmaceutical Description PRIOR AUTHORIZATION SPECIALIST ( REMOTE ) WHO WE ARE Polaris Pharmacy Services is an industry leader in… more
    Polaris Pharmacy Services, LLC (08/15/25)
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  • Pricing Analyst - Remote

    Prime Therapeutics (Tallahassee, FL)
    …analysis to include 1 year of experience in Pharmacy Benefit Management (PBM), claims processing , healthcare, and/or related field + Must be eligible to ... analysis of Prime's financial pricing programs, including data extraction, storage, manipulation, processing and analysis + Analyze claims data of varying… more
    Prime Therapeutics (08/13/25)
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  • Manager, Operations -System Operations…

    Molina Healthcare (Miami, FL)
    …Provides leadership and direction to MMS Operational Units management staff (eg, Claims Processing , Provider Services, Provider Enrollment, Finance, Managed Care ... or equivalent experience **Required Experience** 3 years supervision/management experience in Claims Processing or Provider Services environment and/or any high… more
    Molina Healthcare (07/31/25)
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  • Remote Call Center Representative

    Mass Markets (FL)
    …736), Business Process Management (BPM), Business Process Outsourcing (BPO), Claims Processing , Collections, Customer Experience Provider (CXP), Customer ... have established ourselves as a trusted partner in the industry. We are hiring Remote Call Center Representatives to join our customer support team. This role is… more
    Mass Markets (06/05/25)
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  • Experienced Remote VP BPO Sales

    Mass Markets (FL)
    …736), Business Process Management (BPM), Business Process Outsourcing (BPO), Claims Processing , Collections, Customer Experience Provider (CXP), Customer ... the industry. We are seeking a dynamic and experienced Remote Vice President of BPO Sales to lead our...Services (MFS), OnBrand24, The Sydney Call Center, Valor Intelligent Processing (VIP), BYC Aqua, EastWest BPO, TeleTechnology, and Vinculum.… more
    Mass Markets (06/05/25)
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  • Senior Analyst Pricing - Remote

    Prime Therapeutics (Tallahassee, FL)
    …analysis to include 3 years of experience in Pharmacy Benefit Management (PBM), claims processing , healthcare, and/or related field + Previous experience using ... drives every decision we make. **Job Posting Title** Senior Analyst Pricing - Remote **Job Description** The Senior Pricing Analyst participates in the assessment of… more
    Prime Therapeutics (08/13/25)
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  • Pricing Analyst Sr - Strong SQL/GCP…

    Prime Therapeutics (Tallahassee, FL)
    …analysis to include 3 years of experience in Pharmacy Benefit Management (PBM), claims processing , healthcare, and/or related field. + Previous experience using ... we make. **Job Posting Title** Pricing Analyst Sr - Strong SQL/GCP - Remote **Job Description** The Senior Pricing Analyst participates in the assessment of value… more
    Prime Therapeutics (08/01/25)
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