- Molina Healthcare (St. Petersburg, FL)
- …and demonstrate proficiency in running all applicable risk models including the various CMS models for Medicare Advantage members, the HHS model for Commercial ... Performs analysis across multiple states and lines of business ( Medicare , Medicaid, Marketplace ACA). **KNOWLEDGE/SKILLS/ABILITIES** + Compiling and organizing… more
- Surgery Care Affiliates (Tallahassee, FL)
- …information. + Enter the patient insurance information into patient accounting system ensuring the selection is the appropriate payer and associated financial ... call each patient as part of center compliance with CMS Conditions for Coverage guidelines in contacting patient's prior...and accurate information is entered into the patient accounting system and the procedure scheduled, date of service and… more
- Highmark Health (Tallahassee, FL)
- …drug benefit strategies, drug formularies, and programs specifically for the Medicare Advantage (MA) market. The incumbent will contribute to recommendations for ... Committee review. + Assist in the development and implementation of utilization management programs including but not limited to: prior authorization, dose and… more
- University of Florida (Gainesville, FL)
- …(NCI), the Patient Centered Outcomes Research Institute (PCORI), the Centers for Medicare and Medicaid Services ( CMS ), and state agencies. The Department ... Florida is the flagship university of the state university system , a consistently nationally top ranked public university and...Center, the Chief Information Officer for the UF Health system , Director for Artificial Intelligence for the UF Preston… more
- TEKsystems (Tampa, FL)
- …general surgery. * Strong understanding of CPT guidelines for outpatient surgery and Medicare 's ASC payment system . Skills Surgical Coder, Surgical Coding, ASC, ... * Assign accurate CPT, ICD-10-CM, and HCPCS Level II codes in accordance with CMS , AMA, ASC, and payer-specific guidelines. * Apply correct modifiers to reflect the… more
- Cognizant (Tallahassee, FL)
- …CPT, HCPCS, ICD-9 + Experience with UB/institutional ( CMS -1450) and/or professional ( CMS 1500) claims + Knowledge of Medicare billing & payment and ... Responsible for reviewing the data in the claim processing system (Facets) and comparing it with the corresponding UB,...Assigned special projects or other duties as determined by management . + Will work closely with other departments **Desired… more
- Cognizant (Tallahassee, FL)
- …ICD-10 * Experience making payments with UB/institutional ( CMS -1450) and/or professional ( CMS 1500) claims * Knowledge of Medicare / Medicaid payment and ... Responsible for reviewing the data in the claim processing system and comparing with corresponding UB or HCFA paper...Assigning special projects or other duties as determined by management . **What you need to have to be considered:**… more
- AdventHealth (Wesley Chapel, FL)
- …is responsible for, but not limited to: Coordination of Care, Centers for Medicare & Medicaid Services ( CMS ) Conditions of Participation, Social Services ... and central Pasco. **The role you'll contribute:** The Care Management Manager is under the general leadership of the...Manager is under the general leadership of the Care Management Facility Director and has the responsibility of the… more
- AdventHealth (Palm Coast, FL)
- …evidence of performance with the State of Florida regulatory agencies, basic Centers for Medicare & Medicaid Services ( CMS ) regulations, as well as other local, ... execution of action plans around such activities as they relate to practice management and operations. The Executive Director of Practice Operations will also be… more
- AdventHealth (Minneola, FL)
- … department, including but not limited to: Coordination of Care, Centers for Medicare & Medicaid Services ( CMS ) Conditions of Participation, Discharge Planning, ... spirit in the Minneola community. **The role you'll contribute:** The Care Management Facility Director has full accountability and oversight for the overall… more