• Specialist , Appeals & Grievances

    Molina Healthcare (Richmond County, GA)
    …concisely and accurately, in accordance with regulatory requirements. + Research claims processing guidelines, provider contracts, fee schedules and system ... years operational managed care experience (call center, appeals or claims environment). + Health claims processing...center, appeals or claims environment). + Health claims processing background, including coordination of benefits,… more
    Molina Healthcare (10/03/25)
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  • Claim Benefit Specialist

    CVS Health (Franklin, TN)
    …providers, patients, or other stakeholders to resolve any discrepancies or issues related to claims . + Determines if claims processing activities comply with ... codes and other necessary data elements to ensure accurate tracking, reporting, and processing of claims in all appropriate applications. + Conducts reviews and… more
    CVS Health (10/02/25)
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  • HR Specialist - Leave of Absence

    Orlando Utilities Commission (Orlando, FL)
    **OUC - The** **_Reliable_** **One** **,** is presently seeking a **HR Specialist - Leave of Absence** to join the Employee Experience division. At OUC, we don't ... be the go-to person for employee questions and ensure compliance and timely processing of a wide range of programs, from FMLA, ADA accommodations, and retirement.… more
    Orlando Utilities Commission (08/13/25)
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  • Patient Registration Specialist PRN Float…

    Trinity Health (Boise, ID)
    …ensure accuracy. + Accesses information and translates data into information acceptable to the claims processing system. + Prepares claims for return to ... of care. We are looking to hire a motivated and dynamic **Patient Registration Specialist ** to support our team in the **Boise Float Pool!** As a **Patient… more
    Trinity Health (10/10/25)
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  • Dispute Specialist I

    Woodforest National Bank (The Woodlands, TX)
    …the country! The Dispute Specialist I is responsible for investigating and processing debit card and/or ACH dispute claims , and Stop Payments, initiated by ... banks policies and procedures. Key Responsibilities: . Research customer dispute claims by reviewing card transactions, account records and information provided by… more
    Woodforest National Bank (09/17/25)
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  • Claim Specialist

    City of New York (New York, NY)
    …New York, and has a wastewater conveyance and treatment system capable of processing over 1.3 billion gallons of wastewater per day to protect the environment ... is involved in a significant amount of litigation and claims filed with the New York City Comptroller's Office....is seeking qualified candidates for the position of Claim Specialist 2 in the Litigation Support Unit. This position,… more
    City of New York (08/13/25)
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  • Insurance Specialist II - Corporate Patient…

    Guthrie (Sayre, PA)
    Position Summary: Fulfills all requirements of Insurance Specialist I, as well as serving as a group leader by participating in staffing and employment issues. ... Serves as a resource specialist within the department. Trains Insurance Billing Specialists I...insurance billings and appeals. Reviews and analyzes the insurance processing procedures to identify potential problem areas and makes… more
    Guthrie (09/11/25)
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  • Neuroscience LTC Specialist - Chicago North

    Otsuka America Pharmaceutical Inc. (Chicago, IL)
    …of everyday health. In Otsuka's evolved customer engagement model, a Neuroscience LTC Specialist will engage HCPs through a variety of in-person, virtual and digital ... and the approved conditions they treat. The Neuroscience LTC Specialist will report directly to the respective Area Business...offered money for equipment fees or some other application processing fee, even if claimed you will be reimbursed,… more
    Otsuka America Pharmaceutical Inc. (10/01/25)
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  • Account Specialist

    Robert Half Office Team (Miami, FL)
    …position, ideal for professionals with a strong background in customer service, claims processing , and accounts receivable functions. Responsibilities: * Manage ... Description We are looking for a detail-oriented Account Specialist to join our team in Miami, Florida....and providing effective resolutions. * Strong knowledge of billing, claims processing , and revenue accounting. * Ability… more
    Robert Half Office Team (10/10/25)
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  • Appeals Quality and Training Specialist

    Martin's Point Health Care (Portland, ME)
    …(USFHP). + Demonstrates advanced knowledge of enrollment / disenrollment guidelines, claims processing and plan benefits necessary to exercise decision-making ... Independently and with judgement, conducts multi-faceted, complex investigations through claims review, provider credentialing, authorization processing , timeliness… more
    Martin's Point Health Care (10/07/25)
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