- BayCare Health System (Clearwater, FL)
- …1 day in office required Equal Opportunity Employer Veterans/Disabled **Position** Grievance Specialist -Health Plan **Location** Clearwater:Park Place | Business ... records. Triage, plan, and execute intake of Appeals and Grievance submissions. + Keeping track of deadlines, ensuring all...and contribute to the development of best practices for grievance and appeal resolution. + Adhere to HIPAA requirements,… 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
- MyFlorida (Tallahassee, FL)
- PROGRAM SPECIALIST IV-DOE - 48003644 Date: Dec 19, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify Website ... . Requisition No: 867248 Agency: Department of Education Working Title: PROGRAM SPECIALIST IV-DOE - 48003644 Pay Plan: Career Service Position Number: 48003644… more
- WestCare Foundation (Key West, FL)
- …thereafter. Education: + High School Diploma or GED required with Prevention Specialist certification within 1 year. + Graduation from an accredited college with ... 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)
- …appeals and grievances using support systems to determine appropriate appeals 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 guidelines. * Meets claims production standards set by the… more