- 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 3 years of experience to join our team. The ideal candidate will have strong technical skills in MS Excel and… more
- Healthfirst (FL)
- …+ Independently manage a caseload of grievances through the full case lifecycle, from written acknowledgement to investigation, resolution, and written member ... resolution letters. + Conduct detailed research by collaborating cross-functionally with internal departments (eg, Member Services, Provider Operations, Clinical, Enrollment, Pharmacy) to identify root causes and recommend appropriate resolutions. + Partner… more
- Molina Healthcare (Miami, FL)
- …subcontractors and enrollees. * Monitors all formal and informal grievances with Grievance personnel to identify trends or problem areas of access and care ... delivery. Assists enrollees in the grievance process at the HMO and State levels and...Care including working with the State External Advocate, Enrollment Specialist and Ombudsmen on issues of access to medical… more
- HCA Healthcare (Atlantis, FL)
- …**Introduction** Do you have the career opportunities as a(an) Risk Management Specialist you want with your current employer? We have an exciting opportunity ... Do you want to work as a(an) Risk Management Specialist where your passion for creating positive patient interactions...of claims and pretrial preparation. Also responsible for the grievance process and the timely response and documentation of… more
- MyFlorida (Tallahassee, FL)
- PROGRAM SPECIALIST IV-DOE - 48003645 Date: Sep 9, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify Website ... . Requisition No: 860702 Agency: Department of Education Working Title: PROGRAM SPECIALIST IV-DOE - 48003645 Pay Plan: Career Service Position Number: 48003645… more
- MyFlorida (Tallahassee, FL)
- LABOR RELATIONS SPECIALIST - 67072413 Date: Aug 27, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify Website ... 855708 Agency: Agency for Persons with Disabilities Working Title: LABOR RELATIONS SPECIALIST - 67072413 Pay Plan: SES Position Number: 67072413 Salary: $45,000.00… more
- WestCare Foundation (Key West, FL)
- Prevention Specialist Job Details Job Location Key West - 1205 4th - Key West, FL Position Type Full Time Education Level 4 Year Degree Salary Range $21.22 - $21.22 ... deal with difficult people + Demonstrated ability to handle a client concern/ grievance according to agency protocol + Demonstrated ability to establish and maintain… more
- Molina Healthcare (Tampa, FL)
- …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 determine response; assures timeliness and appropriateness of responses per state, federal and Molina Healthcare guidelines. + Responsible for meeting production standards set… more