- Elevance Health (Miami, FL)
- **Title: Grievance/ Appeals Analyst I** **Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person training ... unless an accommodation is granted as required by law._ " The **Grievance/ Appeals Analyst I** is an entry level position in the Enterprise Grievance &… more
- Highmark Health (Tallahassee, FL)
- …of a grievance/appeal; documents, investigates, refers and coordinates grievances and appeals ; initiates a case file for each grievance and appeal; ensures ... all involved parties. + Participate in workgroup meetings to address trends in appeals and grievances and to work on process improvement initiatives with cross… more
- TEKsystems (Tampa, FL)
- …will be on the bill review team specifically working in the backlog of appeals . The Bill Review Analyst position holds accountability for accurate and timely ... and payment of bills to include pre-coding accuracy and adjudication of appeals /provider reconsideration requests. * Examines and adjudicates requests for appeals… more
- MyFlorida (Tallahassee, FL)
- SENIOR CONSUMER SERVICE ANALYST - 41000334 Date: Jul 11, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify Website ... Agency: Office of the Attorney General Working Title: SENIOR CONSUMER SERVICE ANALYST - 41000334 Pay Plan: Career Service Position Number: 41000334 Salary:… more
- MyFlorida (Tallahassee, FL)
- GOVERNMENT ANALYST II - 78003024 Date: Jul 17, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify Website ... Requisition No: 856856 Agency: Commission on Offender Review Working Title: GOVERNMENT ANALYST II - 78003024 Pay Plan: Career Service Position Number: 78003024… more
- Evolent (Tallahassee, FL)
- …Evolent for the mission. Stay for the culture. **What You'll Be Doing:** ** Analyst , Client Analytics** Integrate and analyze claims and enrollment data from multiple ... Evolent's clinical services (ie, specialty care, utilization management, care management, appeals & grievances) + Using analytical tools to integrate various data… more
- Shuvel Digital (Tampa, FL)
- Role: Intel Analyst Location: Tampa, FL Duration: 2+ Years Job Description: Perform all-source and/or open source intelligence analysis to include, but not limited ... Demonstrated ability to write clearly, succinctly, and in a manner that appeals to a wide audience Experience creating methodologies by leveraging existing… more
- Molina Healthcare (FL)
- …+ Experience working with complex, often highly technical teams + Appeals & Grievance, healthcare services, or claims background **Preferred License, Certification, ... Association** Certified Business Analysis Professional (CBAP), Certification from International Institute of Business Analysis preferred To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job… more
- Intermountain Health (Tallahassee, FL)
- …updates to charging/coding/NCCI regulations and/or errors, and regarding audits and appeals , to facilitate corrective action planning for improved processes. 7. ... Complies with all CMS, Federal and State regulations, and payor guidelines, and ensures consistent and compliant application with charge/coding capture, charge editing, and audit and reimbursement practices. Researches and collaborates on regulation updates to… more
- Intermountain Health (Tallahassee, FL)
- **Job Description:** The HIM Coding Audit Training Analyst Coordinator provides advanced training to hospital coding staff, compliance, CDI, physicians, and clinical ... providers, clinical staff, compliance and the CDI team. + Audits and creates appeals for all payer and regulatory denials and downgrades and provides in-depth coding… more
- Capgemini (Pensacola, FL)
- …software systems to create Prescription cases and determine coverage, determination and appeals process + Good written and verbal communication skills + The ability ... to display soft skills while moving the call forward + Meeting or exceeding government mandated timelines + Complying with turnaround time, productivity, and quality standards + Conveying resolution to beneficiary or provider via direct communication and… more