• Provider Appeals & Grievances

    Cognizant (Tallahassee, FL)
    ** Provider Appeals & Grievances Specialist ** (remote) This is a remote position open to any qualified applicant that lives in the United States. ... **Summary:** We are seeking a dedicated Provider Appeals & Grievance Specialist ...directly with CMS Billing and Coding-Medical Insurance Knowledge of Member/ Provider Appeals and Grievances , processes,… more
    Cognizant (10/07/25)
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  • Specialist , Appeals

    Molina Healthcare (FL)
    …+ Responsible for the comprehensive research and resolution of the appeals , dispute, grievances , and/or complaints from Molina members, providers ... to ensure that internal and/or regulatory timelines are met. + Research claims appeals and grievances using support systems to determine appeal and grievance… more
    Molina Healthcare (10/03/25)
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  • Grievance Specialist -Health Plan

    BayCare Health System (Clearwater, FL)
    …is completed and filed appropriately, and communicating effectively with all parties involved. + Provide reports on the status of grievances and provide ... updates to management. + Identify trends or recurring issues in member grievances and appeals and recommend process improvements to prevent future occurrences. +… more
    BayCare Health System (09/30/25)
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