- University of Miami (Coral Gables, FL)
- …of medical terminology, healthcare billing and reimbursement principles, Federal , State, Medicare and other applicable government regulations pertaining ... of Medicare Coverage Analysis (MCA), facilitating research billing, financial compliance and proper reimbursement, as well as to process basic budgets and… more
- CVS Health (Tallahassee, FL)
- …oversight of DSNP/MMP complex populations (Dual-Eligible Special Needs Plan / Medicare -Medicaid Plan) * Develop and lead clinical strategy and objectives for ... as needed. * Outward facing position to interact and collaborate with medical / physical professional associates, the local provider community, state regulatory… more
- Banner Health (FL)
- …to our award-winning patient care. POSITION SUMMARY This position evaluates medical records, provides clinical and surgical abstraction for full range of ... department projects, validation edits and/or revisions. CORE FUNCTIONS 1. Analyzes medical information from medical records. Accurately codes diagnostic and… more
- Humana (Tallahassee, FL)
- …of our caring community and help us put health first** The Senior Inpatient Medical Coding Professional extracts clinical information from a variety of medical ... in-depth evaluation of variable factors. **Responsibilities** The Senior Inpatient Medical Coding Professional confirms appropriate diagnosis related group (DRG)… more
- CenterWell (Deerfield Beach, FL)
- …Doctors, Advanced Practice professionals, Pharm D, Care Coach Nurses, Medical Assistants, Behavioral Health, Specialists, Quality Based Coders, Referral Coordinators ... accordance with standards of care. . Follows level of medical care and quality for patients and monitors care..."on-call" program of Conviva as needed. . Assures personal compliance with licensing, certification, and accrediting bodies. . Spend… more
- Banner Health (FL)
- …Medicine, Physician Practice Coding Team** is looking for an **experienced Medical Coder with General Medicine: Multi-Specialty experience.** This is a skilled ... for contributing to our award-winning patient care. POSITION SUMMARY Evaluates medical records, provides clinical and surgical abstraction and assigns appropriate… more
- Community Health Systems (Key West, FL)
- …between medical staff, administration, and hospital departments to ensure compliance with accrediting bodies, regulatory requirements, and hospital bylaws. The ... **Job Summary** The Medical Staff Coordinator is responsible for coordinating credentialing,...in accordance with The Joint Commission (TJC), Centers for Medicare and Medicaid Services (CMS), and state regulations. +… more
- Alight (FL)
- …process improvement. Must interact well professionally with colleagues. **Responsibilities** + Maintaining compliance with all Medicare CMS and Compliance ... **Requirements** + Enhanced (SME) for Customer Service best practices, Insurance & Compliance processes, and Medicare (AHIP). + Facilitate independently managing… more
- Elevance Health (FL)
- …of managerial experience is strongly preferred + Experience with IRE/Maximus and Medicare compliance , programs, guidelines, and processes are strongly preferred. ... regulated audits. + Oversight of the IRE portions of Medicare audits and universe production. + Serves as a...plan and policy changes and to ensure state and federal regulatory compliance and resolution within the… more
- Evolent (Tallahassee, FL)
- …platforms. + No current exclusions, sanctions, or disciplinary actions by **state or federal healthcare programs ( Medicare , Medicaid, OIG, or GSA).** Join us at ... for the culture. **What You'll Be Doing:** Evolent is seeking an **Associate Medical Director - Cardiovascular Medicine** to play a critical role in **Performance… more