- Humana (Tallahassee, FL)
- …first** The Medical Director relies on medical background and reviews health claims . The Medical Director work assignments involve moderately complex to complex ... skills, with prior experience participating in teams focusing on quality management, utilization management, case management, discharge planning and/or home… more
- Highmark Health (Tallahassee, FL)
- …of Healthcare: lower per capita health care costs, improved outcomes from and quality of care received, and optimal member/patient and provider experiences with care ... actionable opportunities for improving health and healthcare outcomes and clinical quality and costs of care, efficiently and effectively managing projects to… more
- Prime Therapeutics (Tallahassee, FL)
- …+ Select, manage, and evaluate external legal counsel to ensure high- quality representation + Oversee Prime's Records and Information Management (RIM) program, ... and regulations such as HIPAA, Anti-Kickback Statute, and False Claims Act, with a focus on PBM and managed...new ideas and work collaboratively to provide the highest quality of care and service to our members. If… more
- HCA Healthcare (Sunrise, FL)
- …Nurse (LPN or LVN) in Occupational Health coordinates and delivers high quality , employee-centered care by performing a variety of delegated patient care services. ... Assisting RN on follow-ups and management of work injuries claims . Maintains a safe and therapeutic environment ....leaders and contributes to the teamwork essential to ensuring quality care to employees . Assisting RN with annual… more
- NHS Management, LLC (Tallahassee, FL)
- …standards governing long-term care facilities to ensure that the highest degree of quality care can be provided to the residents at all times. PRIMARY FUNCTIONS ... areas that need improvements or change. 3. Eliminate/reduce resident liability claims through use of corporate policies and established customer service program.… more
- Molina Healthcare (Tampa, FL)
- …performance goals established for the position in the areas of: Call Quality , Attendance, Adherence and other Contact Center objectives. * Able to proactively ... member eligibility and covered benefits, Provider Portal, and status of submitted claims . * Ability to effectively communicate in a professionally setting. **Job… more
- Walgreens (Tamarac, FL)
- …to Company policies and procedures in relation to pharmacy errors and the Quality Improvement Program. + Strictly adheres to the Walgreen Co. policy regarding Good ... Maintains knowledge of Company asset protection techniques, and files claims for warehouse overages (merchandise received, but not billed), shortages… more
- AdventHealth (Altamonte Springs, FL)
- …Team of any coding or coding related issues that adversely impact the claims processing, coding accuracy, and compliance f. Takes responsibility for the unbilled in ... attention to detail, thoroughness, and accuracy in daily work * Completes high quality work in accordance with outlined standards and procedures within defined time… more
- Datavant (Tallahassee, FL)
- …procedures accordingly. + Meet and maintain the department's productivity and quality assurance expectations. + Responsible for following all company policies and ... fields would be beneficial: Data Entry, Medical Records, Health Care, Insurance Claims Processing and Proof Reading/Editing of Documents + Ability to stay organized… more
- Humana (Tallahassee, FL)
- …The Corporate Medical Director relies on medical background and reviews health claims and preservice appeals. The Corporate Medical Director works on problems of ... need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel,… more