• Medicare Grievances

    Humana (Tallahassee, FL)
    …Medical Director relies on medical background and reviews health claims and preservice appeals . The Corporate Medical Director works on problems of diverse scope ... and complexity ranging from moderate to substantial. The Corporate Medical Director provides medical interpretation and decisions about the appropriateness of… more
    Humana (06/18/25)
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  • Medical Director - Medicare

    Humana (Tallahassee, FL)
    …Director (CMD) relies on medical background to review health claims and preservice appeals . The Corporate Medical Director works on problems of diverse scope ... and complexity ranging from moderate to substantial. The Corporate Medical Director provides medical interpretation and decisions regarding the appropriateness and… more
    Humana (04/24/25)
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  • Mood Area Business Specialist, Jacksonville, FL…

    J&J Family of Companies (Jacksonville, FL)
    …(ie, eligibility and benefit verification, pre-authorization, billing, coding, claims, and appeals / grievances ); REMs certification; Medicare and Medicaid ... business acumen and skilled prioritization. The ABS must comply with all corporate policies, SOPs, and applicable federal and state healthcare laws. **About… more
    J&J Family of Companies (06/21/25)
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