- MyFlorida (St. Petersburg, FL)
- …. + Enters Services and tracking process for Directions Behavioral Health program, review clinical notes match claims and authorization. Knowledge, skills and ... as needed. + Processes stat referrals as assigned. Data Review + Verify data requested from source documents is...statistical reports in Logi. + Assist the Business Operations Specialist in the development and implementation of guidelines to… more
- Elevance Health (Tampa, FL)
- …clinical documentation supports the conditions and DRGs billed and reimbursed. Specializes in review of Diagnosis Related Group (DRG) paid claims . **How you will ... make an impact:** + Analyzes and audits claims by integrating medical chart coding principles, clinical guidelines, and objectivity in the performance of medical… more
- MyFlorida (Tallahassee, FL)
- …You Will Do: This is an OPS Employment Security Representative II- Employment Review Specialist position in the Department of Commerce's Reemployment Assistance ... issues and the chargeability of employer accounts for benefit payments on claims . This may be accomplished telephonically, through written correspondence, or through… more
- MyFlorida (Fort Lauderdale, FL)
- …You Will Do: This is an OPS Employment Security Representative II- Employment Review Specialist position in the Department of Commerce's Reemployment Assistance ... issues and the chargeability of employer accounts for benefit payments on claims . This may be accomplished telephonically, through written correspondence, or through… more
- MyFlorida (Orlando, FL)
- …You Will Do: This is an OPS Employment Security Representative II- Employment Review Specialist position in the Department of Commerce's Reemployment Assistance ... applying laws and policies to determine the eligibility of reemployment assistance claims using the CONNECT system. This includes gathering claimant and employer… more
- Banner Health (FL)
- …accurate coding based on documentation for positive outcomes. 5. Performs ongoing audits/ review of inpatient and/or outpatient medical records to assure the use of ... coding expertise to resolve issues and support appropriate reimbursement. Proficiency in claims software to address coding edits and claim denials utilizing multiple… more
- AdventHealth (Tampa, FL)
- …for receiving and addressing accounts within 72 hours of being routed to the claims edit work queue and coding review needed work queue. Qualifications **T** ... billed as well as ensure we are billing clean claims . The APC Coordinator will assist in the oversight...education. **The val** **ue you'll bring to the team:** Review and analyze claim denials to perform the appropriate… more
- Molina Healthcare (Tampa, FL)
- …Managed Care Experience in the specific programs supported by the plan such as Utilization Review , Medical Claims Review , Long Term Service and Support, or ... of a formal appeal being submitted. + Independently re-evaluates medical claims and associated records by applying advanced clinical knowledge, knowledge of… more
- MyFlorida (Largo, FL)
- …CANCY **ANTICIPATED VACANCY** CANCY ACCOUNTANT III - HEALTH INSURANCE BILLING SPECIALIST FLORIDA DEPARTMENT OF VETERANS' AFFAIRS Agency Headquarters, Mary Grizzle ... Accounts Receivable billing software systems. + Perform third party claims processing and collection activities for all payors of...any other payer for the State Veterans' Homes. + Review and monitor resident accounts ensuring that the account… more
- MyFlorida (Orlando, FL)
- …AGENCY FOR PERSONS WITH DISABILITIES POSITION: Human Services Program Specialist - Career Service WORKING TITLE: Supported Living Liaison POSITION ... obtains documented evidence of provider corrections to 100% of the review findings. Tracks, calculates, negotiates, and processes recoupment following the Agency's… more