Top 267 Remote program eligibility specialist Jobs in Florida

Senior Claim Benefit Specialist - Remote
CVS Health —Florida
- $18.50 - $42.35 an hour
- Full-time
- Remote
- Mid-level
- High school diploma or GED
- Mentoring
- Health insurance
- Dental insurance
Housing Program Specialist
US Assistant Secretary for Public and Indian Housing —Jacksonville, FL
- $106,437 - $158,322 a year
- Online Application
- Background check
- Customer service
- Pass drug screening
- Flexible schedule
Physical Therapist-Full-Time Hybrid- 3 Days on-site and 2 days Telehealth Outpatient Clinic-$10K Sign -On Bonus
CORA Physical Therapy —Leesburg, FL
- Full-time
- Hybrid work
- Physical & Rehabilitation Medicine
- Mid-level
- Outpatient experience
- Continuing education credits
- Disability insurance
Quick Apply
Medical AR Billing Specialist
Metro Healthy Communities —Saint Petersburg, FL
- From $20 an hour
- Full-time
- Background check
- Microsoft Excel
- Word processing
- Wellness program
- Health savings account
Quick Apply
Field Technician – Fall Protection Systems
Diversified Fall Protection —Jacksonville, FL
- $28 - $32 an hour
- Weekends as needed
- Background check
- Heavy lifting
- Construction site
- Disability insurance
- Health insurance
Quick Apply
10d
Physical Therapist-Hybrid-Full-Time 3 Days on-site-2 Days Telehealth Outpatient Clinic- $10K Sign-On Bonus
CORA Physical Therapy —Kissimmee, FL
- Full-time
- Hybrid work
- Physical & Rehabilitation Medicine
- Mid-level
- Outpatient experience
- Continuing education credits
- Disability insurance
Quick Apply
Site Restoration Specialist (Skilled Laborer)
Mac Construction —Holiday, FL
- $20 - $25 an hour
- Overtime
- Background check
- Construction site
- English
- Paid holidays
- Health insurance
Quick Apply
Agency Growth Manager - Bilingual Spanish
TROVE GROUP INC —Tampa, FL
- $75,000 - $110,000 a year
- Full-time
- Microsoft Word
- Spanish
- Microsoft Outlook
- Disability insurance
- Health insurance
Quick Apply
Deputy Director- Pro Bono (partially remote)
Gulfcoast Legal Services —Saint Petersburg, FL
- From $82,400 a year
- Overtime
- Hybrid work
- Background check
- Writing skills
- Office
- Health insurance
- Dental insurance
Quick Apply
Medical Field Case Manager
Enlyte —Sanford, FL
- $70,600 - $80,000 a year
- Full-time
- Nursing
- Microsoft Outlook
- RN License
- Travel reimbursement
- Health savings account
Workers' Compensation Field Case Manager
Enlyte —Gainesville, FL
- $71,000 - $88,000 a year
- Full-time
- Nursing
- Microsoft Outlook
- RN License
- Travel reimbursement
- Health savings account
Medical Field Case Manager
Enlyte —Vero Beach, FL
- $70,000 - $95,000 a year
- Full-time
- Nursing
- Microsoft Outlook
- RN License
- Travel reimbursement
- Health savings account
Workers' Compensation Field Case Manager
Enlyte —Ocala, FL
- $63,000 - $88,000 a year
- Full-time
- Nursing
- Microsoft Outlook
- RN License
- Travel reimbursement
- Health savings account
Workers' Compensation Case Manager
Enlyte —Melbourne, FL
- $71,000 - $88,000 a year
- Full-time
- Nursing
- Microsoft Outlook
- RN License
- Travel reimbursement
- Health savings account
Workers' Compensation Field Case Manager
Enlyte —Fort Pierce, FL
- $71,000 - $88,000 a year
- Full-time
- Nursing
- Microsoft Outlook
- RN License
- Travel reimbursement
- Health savings account
Workers' Compensation Field Case Manager
Enlyte —Orlando, FL
- $71,000 - $88,000 a year
- Full-time
- Nursing
- Microsoft Outlook
- RN License
- Travel reimbursement
- Health savings account
Medical Field Case Manager
Enlyte —Wesley Chapel, FL
- $63,000 - $90,000 a year
- Full-time
- Nursing
- Microsoft Outlook
- RN License
- Travel reimbursement
- Health savings account
Medical Field Case Manager
Enlyte —West Palm Beach, FL
- $70,000 - $90,000 a year
- Full-time
- Nursing
- Microsoft Outlook
- RN License
- Travel reimbursement
- Health savings account
Patient Support Operator (Full-time) On-site
CenterWell Senior Primary Care —The Villages, FL
- $16.25 - $18.00 an hour
- Online Application
- Background check
- Medical office experience
- Primary Care
- Paid jury duty
- Health savings account
Patient Support Operator (Part-Time) On-site
CenterWell Senior Primary Care —The Villages, FL
- $16.25 - $18.00 an hour
- Part-time
- Background check
- Medical office experience
- Primary Care
- Paid jury duty
- Health savings account

I want to receive the latest job alert for remote program eligibility specialist in florida

By signing in to your account, you agree to SimplyHired's Terms of Service and consent to our Cookie and Privacy Policy.

Explore jobs in more locations

remote program eligibility specialist jobs near florida

Senior Claim Benefit Specialist - Remote

CVS Health -
Florida

Apply Now

Job Details

Full-time
$18.50 - $42.35 an hour

Benefits

Health insurance
Dental insurance
Paid time off
Vision insurance

Qualifications

High school diploma or GED
Health insurance knowledge

Full Job Description

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.

Position Summary
Reviews and adjudicates complex, sensitive, and specialized medical claims in accordance with established plan processing guidelines. Functions as a subject matter expert by providing coaching, and offering guidance on escalated or technically challenging issues. Supports customer service operations by addressing inquiries and resolving issues to ensure a positive member experience.

Additional Responsibilities

Reviews pre‑specified claims and those that exceed specialist adjudication authority or processing expertise.
Applies medical necessity guidelines, determines coverage, verifies eligibility, identifies discrepancies, and implements cost‑containment measures to support accurate claim adjudication.
Ensures compliance with all regulatory requirements and confirms that payments align with company policies and procedures.
Identifies and reports potential overpayments, underpayments, and other claim irregularities.
Performs claim rework calculations as needed.
Trains and mentors as needed to enhance team performance and technical proficiency.
Conducts outbound calls to obtain required information for claims or reconsideration requests.

Required Qualifications

Minimum of 18 months of medical claim processing experience with a health insurance payor or third‑party administrator.
Proven success working in a high‑volume, production‑driven environment.
Demonstrated ability to manage multiple assignments with accuracy, efficiency, and attention to detail.

Preferred Qualifications

Self-Funding experience
DG system knowledge

Education

High School Diploma required
Preferred Associates degree or equivalent work experience.

Anticipated Weekly Hours

Time Type

Full time

Pay Range

The typical pay range for this role is:

$18.50 - $42.35

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors.

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great benefits for great people

We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.

This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.

Additional details about available benefits are provided during the application process and on Benefits Moments.

This job does not have an application deadline, as CVS Health accepts applications on an ongoing basis.

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Apply Now

Refine Your Search

remote program eligibility specialist jobs in florida

Senior Claim Benefit Specialist - Remote

Housing Program Specialist

Physical Therapist-Full-Time Hybrid- 3 Days on-site and 2 days Telehealth Outpatient Clinic-$10K Sign -On Bonus

Medical AR Billing Specialist

Field Technician – Fall Protection Systems

Physical Therapist-Hybrid-Full-Time 3 Days on-site-2 Days Telehealth Outpatient Clinic- $10K Sign-On Bonus

Site Restoration Specialist (Skilled Laborer)

Agency Growth Manager - Bilingual Spanish

Deputy Director- Pro Bono (partially remote)

Medical Field Case Manager

Workers' Compensation Field Case Manager

Medical Field Case Manager

Workers' Compensation Field Case Manager

Workers' Compensation Case Manager

Workers' Compensation Field Case Manager

Workers' Compensation Field Case Manager

Medical Field Case Manager

Medical Field Case Manager

Patient Support Operator (Full-time) On-site

Patient Support Operator (Part-Time) On-site

I want to receive the latest job alert for remote program eligibility specialist in florida

Related Searches

Explore jobs in more locations

Job Seeker Tools

Employer Tools

Browse

Stay Connected