- Polaris Pharmacy Services, LLC (Fort Lauderdale, FL)
- …rejected pharmacy claims to ensure maximum payer reimbursement and timely billing to eliminate financial risks to Polaris and their customers. The Prior ... claims to ensure maximum payer reimbursement and timely billing to eliminate financial risks to Polaris and their...in a timely manner + Review and work convert billing exception reports to ensure claims are… more
- Highmark Health (Tallahassee, FL)
- …(AHFI) **SKILLS** + Must have knowledge of provider facility payment methodology, claims processing systems and coding and billing proficiency + Must ... hospital or health insurance setting + 1 year in professional billing , facility Patient Financial Services, HIM, Internal Audit, Professional/Facility Reimbursement… more
- AdventHealth (Maitland, FL)
- …rules, regulations, policies, laws, and guidelines that impact healthcare billing . **Reimbursement-30%** + Supports Managed Care leadership in contract negotiations ... + Applies significant understanding of medical coding systems affecting the adjudication of claims to include ICD-9/10, CPT, HCPCS II, DRG and revenue codes +… more
- Banner Health (FL)
- …and for quality assurance in the alignment of clinical documentation and billing codes. Works with clinical documentation improvement and quality management staff ... documentation to improve the quality of clinical documentation and correctness of billing codes prior to claim submission; to identify possible opportunities for… more
- CenterWell (Tallahassee, FL)
- …internal policies and procedures. Establishes industry best practices and KPIs for billing and, cash collections for both patient and payers. Innovative leader that ... internal policies and procedures. Establishes industry best practices and KPIs for billing and collections for both patient and payers. Innovative leader that will… more
- Cardinal Health (Tallahassee, FL)
- …supervises and manages audits to determine organizational integrity of billing for professional (physician) services and/or hospital (technical) services, including: ... detection and correction of documentation, coding, and billing errors and/or medical necessity of services billed. Particular areas of focus include: evaluation of… more
- Sedgwick (Tampa, FL)
- …and government entities. The auditor will apply client specified billing guidelines and/or Generally Accepted Principles and Standards ("GAPS"). **ESSENTIAL ... RESPONSIBILITIES** + Ability to understand and apply clients' billing guidelines and standards. + Work with client to develop or enhance billing protocol. +… more
- Otsuka America Pharmaceutical Inc. (Tallahassee, FL)
- …and their staff on matters related to access, coverage, reimbursement processes, claims submissions, and coding requirements + Analyze payer criteria and provide ... benefit verifications, prior-authorization requirements, or equivalent experience in patient access, billing , and coding in rare disease + Strong knowledge of… more
- Evolent (Tallahassee, FL)
- …RVUs, bundled payments, etc. is preferred + Working knowledge of healthcare claims ; specifically, differences between institutional vs professional billing and ... into succinct presentations. + Perform research and analysis of complex healthcare claims , eligibility, and pharmacy data to make recommendations based on relevant… more
- University of Miami (Miami, FL)
- …the organization by ensuring accurate, compliant, and complete charge capture and billing processes. This role is responsible for analyzing clinical and financial ... a pivotal role in ensuring revenue integrity through: trend reporting and claims analysis, development of payor scorecards, Charge Description Master (CDM) reviews,… more