- BrightSpring Health Services (Fort Lauderdale, FL)
- …basic mathematical calculations (eg, converting milligrams) + May resolve issues of denials identified through adjudication, and follow-up claims in Point of Sale ... (POS) + Maintains current knowledge of Medicaid claim regulations and processes + May produce reports and keep management informed of unpaid claims and claims pending follow-up + Provides excellent customer service to external and internal customers in… more
- Molina Healthcare (Orlando, FL)
- …reported accurately to maintain compliance and to minimize risk and denials . **KNOWLEDGE/SKILLS/ABILITIES** + Performs on-going chart reviews and abstracts diagnosis ... codes + Develop an understanding of current billing practices in provider offices to ensure that diagnosis and CPT codes are submitted accordingly + Documents results/findings from chart reviews and provides feedback to management, providers, and office staff… more
- University of Miami (North Miami, FL)
- …co-pay, and previous balance collections, registration processing time, and denials + Maintains harmonious and collaborative working relationship with all ... healthcare team members. + Adheres to University and unit-level policies and procedures and safeguards University assets. This list of duties and responsibilities is not intended to be all-inclusive and may be expanded to include other duties or… more
- MyFlorida (Tallahassee, FL)
- …rule development and rulemaking, federal bankruptcy matters, and the denials of exemptions from disqualification from employment. Informal Hearing Officer: ... Sit as an informal hearing officer on Agency matters, most particularly regulatory actions assigned to the attorneys located in the Agency field offices. Legislation: Work with Agency personnel in developing and reviewing proposed rules for both substantive… more
- Ascension Health (Pensacola, 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 Pensacola** + As part of Ascension - the largest non-profit health system in the US and the world's largest Catholic health system - Sacred Heart Hospital Pensacola… more
- Butterfly Effects (Deerfield Beach, FL)
- …staff members. The Medical Collections team is responsible for responding to denials , medical records requests, and other payor requests. The ideal candidate would ... have 5+ years of experience managing a team of 10 or more team members. They would have experience with a mid to large-sized company and have a strong background in denial management. What are your job responsibilities? The Post-bill Manager must be able to… more
- Evolent (Tallahassee, FL)
- …obtain additional pertinent clinical history/information; notifies of approvals and denials , giving clinical rationale, while providing optimum customer service ... through professional/accurate communication and maintaining NCQA and health plans required timeframes. + Documents all communication with medical office staff and/or treating provider. + Practices and maintains the principles of utilization management by… more
- Evolent (Tallahassee, FL)
- …obtain additional pertinent clinical history/information; notifies of approvals and denials , giving clinical rationale, while providing optimum customer service ... through professional/accurate communication and maintaining NCQA and health plans required timeframes. + Documents all communication with medical office staff and/or treating provider. + Practices and maintains the principles of utilization management by… more
- Aveanna Healthcare (St. Petersburg, FL)
- …or instruction. + Documents effectively resulting in no technical or clinical denials subsequent to review of documentation by payers + Maintain effective ... communication between staff, healthcare team members and family. Serve as a resource consultant for clinical staff. + Supervises other personnel (OTA, HHA) as applicable. + Completes OASIS assessments where allowed by state professional practice and… more
- BAYADA Home Health Care (Orlando, FL)
- …set by the Director of MCM. + Prevent or decrease the occasion of Medicare denials by assuring proper coding on the plan of care and accurate OASIS documentation. + ... Provide support and communication to all disciplines within the service. + Provide customer service/education and act as a resource to Medicare Certified Offices with regards to CMS guidelines, Home Care Coding, PDGM guidelines and billing related issues. +… more