- AdventHealth (Maitland, FL)
- …or incomplete pre-authorizations with third-party payers to minimize authorization related denials through phone calls, emails, faxes, and payer websites, updating ... documentation as needed + Corrects demographic, insurance, or authorization related errors and pre-bill edits + Meets or exceeds accuracy standards and ensures integrity of patient accounts by working error reports as requested by leadership and entering… more
- Veterans Affairs, Veterans Health Administration (West Palm Beach, FL)
- …and supported. Such efforts are conducted to ensure the accuracy of billing denials and prevention against fraud and abuse and to optimize the medical center's ... authorized reimbursement for utilization of resources provided. Work Schedule: Monday - Friday, 8:00 am - 4:30 pm Telework: Not Available Virtual: This is not a virtual position. Functional Statement #: 40410F Relocation/Recruitment Incentives: Not Authorized… more
- Ascension Health (Miramar Beach, FL)
- …+ Provides appropriate documentation that meets insurance company requirements; appeal all denials in a timely manner. + Participates in inpatient and outpatient ... consultation for specialty, which may include on call schedules. **About Ascension Sacred Heart Emerald Coast** As part of Ascension, the largest non-profit health system in the US and the world's largest Catholic health system, Sacred Heart offers + Sacred… more
- Monte Nido (Miami, FL)
- …leadership, clinicians, and admissions regarding status of client authorization, potential denials , and potential for private payment. + Follow workflow and medical ... record requirements for utilization review and clinical documentation across programs. + Leverage understanding of medical necessity criteria and current behavioral health insurance landscape in verbal and written communications with payors to maximize our… more
- Molina Healthcare (Miami, FL)
- …needed to properly evaluate the request. + Accurately enters on-line approvals or denials of requests. Authorized to make and carry out simple prior authorization ... requests within established policies and procedures. + Participates in the development /administration of programs designed to enhance the utilization of targeted drugs and the identification of cost saving pharmacy practices. + Identifies and reports… more
- Intermountain Health (Tallahassee, FL)
- …CDI team. + Audits and creates appeals for all payer and regulatory denials and downgrades and provides in-depth coding review, audit findings, and appeal ... strategies. + Develops and implements training plans for all internal stakeholders including coders at all levels, providers, clinical staff, compliance and the CDI team. + Audits clinical documentation and coding for complex internal and external coding… more
- AdventHealth (Altamonte Springs, FL)
- …ensure appropriate payment for services rendered are received and third-party payer denials are minimized. + Facilitates, coordinates, and oversees the expansion of ... the hospital into long-term, profitable and clinically beneficial relationships with medical schools while developing and overseeing applicable residency program(s). + Continually enhances medical knowledge through a regular program of reading, research,… more
- TEKsystems (Tampa, FL)
- …documentation trends, coding errors, or compliance risks. * Assist with appeals and denials related to coding or medical necessity. * Maintain current knowledge of ... coding updates, payer policies, and compliance regulations affecting ASC services. * Support coding audits and implement feedback from quality reviews. * Monitor and respond to payer coding updates or regulatory changes relevant to ASCs. * Assist in tracking… more
- Chewy (Plantation, FL)
- …date. + Identify and guide on high-risk legal events including accommodation denials and potential termination actions. + Confer, coordinate, negotiate, and partner ... with our LOA TPA, HR, Legal, Payroll, Managers, Benefits, Team Members, and other departments/systems as appropriate. + Based on case performance insights in ServiceNow, partner with sites to enhance their understanding and improve case operation in… more
- BayCare Health System (Tampa, FL)
- …assigned by the supervisor including but not limited to processing concurrent denials . + Preferred experience includes Critical Care or Emergency Nursing RN. ... **Position details:** + **Location:** St Joseph's Hospital(Tampa, FL)- Hybrid after 3 months onsite + **Status:** Full time + **Schedule:** Monday-Friday 8:00 AM - 4:30 PM + **Weekend Requirement:** Every Third Weekend + **On Call:** No **Certifications and… more