- LogixHealth (Dania, FL)
- …contribute to our fast-paced, collaborative environment and will bring your expertise to review and carry out processes on all out of network claims. The ideal ... communication, and a well-rounded knowledge of insurance payers. Key Responsibilities: + Review , organize, and file IDR emails and complete responses + Monitor and… more
- MyFlorida (Tallahassee, FL)
- …performance in accomplishing program objectives. Performs role of Auditor-i n- Ch arge on audit and review projects as assigned. Aids in investigations or spec i ... MANAGEMENT REVIEW SPECIALIST - SES - 80039036 Date: Jul...by the National Institute of Standards and Technology; Internal Audit 's Operating Procedures; and Global Internal Audit … more
- HCA Healthcare (Gainesville, FL)
- …**Introduction** Do you have the career opportunities as a Revenue Integrity Charge Review Analyst you want with your current employer? We have an exciting ... group of colleagues. Do you want to work as a Revenue Integrity Charge Review Analyst where your passion for creating positive patient interactions is valued? If you… more
- Abbott (Orlando, FL)
- …documentation, and refinement of standard operating procedures (SOPs) related to payment review , administration, and audit support. + Monitor trends in denials, ... health and get on with their lives. The Payment Review & Administration SME is responsible for leading the... & Administration SME is responsible for leading the review and analysis of healthcare payments received to ensure… more
- CVS Health (Tallahassee, FL)
- …a collaborative process to implement, coordinate, monitor and evaluate medical review cases. Applies the appropriate clinical criteria/guideline and plan language or ... thinking, evidenced based clinical criteria and clinical practice guidelines. Med Review nurses use specific criteria to authorize procedures/services or initiate a… more
- Molina Healthcare (FL)
- …team responsible for prior authorizations, inpatient/outpatient medical necessity/utilization review , and/or other utilization management activities aimed at ... targeted member population, and triage activities. + Completes staff quality audit reviews. Evaluates services provided and outcomes achieved and recommends… more
- EquipmentShare (Orlando, FL)
- …contractors to ensure compliance with EquipmentShare's building requirements and timelines + Thoroughly review , audit , and take action on errors in all hard copy ... in order to complete projects on time and within contract requirements + Review construction contract and pay requests in accordance with the details contract and… more
- MyFlorida (Fort Pierce, FL)
- …overseeing the work of those staff during an annual or supplemental review . Collecting and requesting information, completing work papers to ensure compliance with ... to the supervisor for proof reading and editing. Participates as a peer reviewer on annual or supplemental compliance reviews with other regional staff. Updating and… more
- City of Boca Raton (Boca Raton, FL)
- …of internal controls within assigned areas. This position reports to the Internal Audit and Compliance supervisor for review , guidance, and assistance with ... to minimize internal control weaknesses. Final product subject to review by Internal Audit and Compliance Supervisor....Final product subject to review by Internal Audit and Compliance Supervisor. + Examines policies, procedures, and… more
- American Express (Sunrise, FL)
- …+ Produce well-written reports detailing and analyzing potentially suspicious activity for review by a secondary reviewer . + Build strong relationships with ... Qualifications:** + A minimum of two years of experience in the legal field, audit , investigations or in the broader financial industry or Bachelor's degree in one… more
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