• Medical Claims Specialist

    Rising Medical Solutions (Tampa, FL)
    The Claims Specialist will assist in reviewing, processing, and coordinating claims accurately in accordance with the program requirements while ensuring ... With offices, providers, and case managers nationwide, RISING provides comprehensive medical claims solutions to our valued clients: insurance carriers,… more
    Rising Medical Solutions (09/27/25)
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  • Patient Claims Specialist

    Modernizing Medicine (Tampa, FL)
    …previous healthcare administration or related experience required + Basic understanding of medical billing claims submission process and working with insurance ... is a world where the software we build increases medical practice success and improves patient outcomes. Founded in...a growing office in Hyderabad, India, and a robust remote workforce across the US, Chile, and Germany. ModMed… more
    Modernizing Medicine (08/08/25)
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  • Specialist , Appeals & Grievances…

    Molina Healthcare (Tampa, FL)
    JOB DESCRIPTION Job Summary Provides support for claims activities including reviewing and resolving member and provider complaints, and communicating resolution to ... to ensure that internal and/or regulatory timelines are met. * Researches claims appeals and grievances using support systems to determine appropriate appeals and… more
    Molina Healthcare (10/26/25)
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  • Associate Specialist , Appeals & Grievances…

    Molina Healthcare (Tampa, FL)
    JOB DESCRIPTION Job Summary Provides entry level support for claims activities including reviewing and resolving member and provider complaints, and communicating ... information system and prepares documentation for further review. * Researches claims issues utilizing systems and other available resources. * Assures timeliness… more
    Molina Healthcare (10/26/25)
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  • Property Adjuster Specialist - Desk

    USAA (Tampa, FL)
    …us special and impactful. **The Opportunity** As a dedicated Property Adjuster Specialist , you will work within established guidelines and framework to investigate, ... evaluate, negotiate, and settle complex property insurance claims presented by or against our members. You will...**Central &** **Eastern Time Zone** . This role is remote eligible for candidates located or willing to self-relocate… more
    USAA (10/24/25)
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  • RN Medical Claim Review Nurse Remote

    Molina Healthcare (Tampa, FL)
    …- 5:00pm. **Essential Job Duties** * Performs clinical/ medical reviews of retrospective medical claim reviews, medical claims and previously denied cases ... management for denial and modification of payment decisions. * Independently re-evaluates medical claims and associated records by applying advanced clinical… more
    Molina Healthcare (10/19/25)
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  • Client Policy Specialist

    Zelis (St. Petersburg, FL)
    …and the personal interests that shape who you are. Position Overview The Client Policy Specialist is a client facing role that will act as the subject matter expert ... support of the growth, and expansion of assigned clients. The Client Policy Specialist will lead the sales overview discussion of new/existing opportunities for the… more
    Zelis (10/10/25)
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  • ADA Accommodation Specialist

    Sedgwick (Tampa, FL)
    …to Work(R) Fortune Best Workplaces in Financial Services & Insurance ADA Accommodation Specialist **PRIMARY PURPOSE OF THE ROLE:** To enhance the ADA process for ... claimants requesting accommodations under the ADAAA; to review complex medical information for temporary and permanent accommodation requests; and to approve and/or… more
    Sedgwick (10/21/25)
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  • Investigator, Coding Special Investigative Unit…

    Molina Healthcare (Tampa, FL)
    …to law enforcement or for payment recovery. **KNOWLEDGE/SKILLS/ABILITIES** + Reviews post pay claims with corresponding medical records to determine accuracy of ... to present those findings. **Preferred License, Certification, Association** + AAPC Certified Medical CPC, CPMA, CPCO or similar specialist preferred + Certified… more
    Molina Healthcare (10/22/25)
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