- AdventHealth (Orlando, FL)
- …Information Management (HIM), Revenue Cycle, Patient Financial Services, Patient Access, AHS Managed Care departments and applicable medical staff of specific ... changes related to denial prevention measures for our contracted managed care payers. The PA role is...Provides trend data of denials to assist in improving payer or care delivery behavior. + OPERATING… more
- AdventHealth (Maitland, FL)
- …the analysis and evaluation of financial and economic data related to healthcare costs and managed care payer rates and reimbursement. The role focuses on ... able to complete extensive and complex financial, operational, and analysis of managed care contracts, proposals, analyze fee schedules, and determine contract… more
- HCA Healthcare (Loxahatchee, FL)
- …contracting issues. + Provides medical consultation on contracting, pricing, and analysis of managed care issues. Offers clinical support for appeals and denials ... regarding delegated utilization management and disease management operations under managed care contracts. Meets all regulatory/contractual/accreditation requirements… more
- Cognizant (Tallahassee, FL)
- …Registered Nurse (RN) . 2-3 years combined clinical and/or utilization management experience with managed health care plan . 3 years' experience in health ... management and managing clinical denials from Providers to the Health Plan/ Payer . The comprehensive process includes analyzing, reviewing, and processing medical… more