- Humana (Miramar, FL)
- …discrepancies between company records and those maintained by the Centers for Medicare and Medicaid Services. This role encompasses a range of moderately complex ... of 3 years' experience in the healthcare industry, with a strong understanding of medical terminology. + Proven background in medical billing, specifically as an… more
- Humana (Tallahassee, FL)
- …submissions to Medicaid/ Medicare . Ensures encounter submissions meet or exceed all compliance standards via analysis of data and develops tools to enhance the ... encounter acceptance rate by Medicaid/ Medicare . Looks for long term improvements of encounter submission...extends outside of work. Among our benefits, Humana provides medical , dental and vision benefits, 401(k) retirement savings plan,… more
- Select Medical (Ormond Beach, FL)
- …and maintain all corporate and clinical services required training and maintain compliance with state/local/ federal regulations + Evaluate, treat, direct, and ... team of clinicians treating primarily outpatient ortho with worker's compensation, medicare and vestibular rehab. Let's foster your growth! **Responsibilities** +… more
- Prime Therapeutics (Tallahassee, FL)
- …specialized needs of the targeted population; for Medicare , is Centers for Medicare & Medicaid Services (CMS) compliance compliant + Utilize Prime's MTM ... operations (eg workflow processes and case management) + Government programs ( Medicare ) knowledge **Preferred Qualifications** + Contact Center experience + Pharmacy… more
- Humana (Tallahassee, FL)
- …analytics expertise, and a proven track record of leveraging data to meet compliance requirements and define and drive business value. The Senior Professional will ... analyze, synthesize, and present data related to benefit utilization, ensuring compliance with state reporting requirements and providing a comprehensive view of… more
- Humana (Tallahassee, FL)
- …in reporting tools such as SSRS or SSIS + Knowledge of Medicaid or Medicare services + Advanced data analytics skills and reporting experience to include working ... Science, Statistics, or related field + Experience working with Medicaid and Medicare data + Expertise in creating analytics solutions to drive decision making… more
- Humana (Tallahassee, FL)
- …best practices, and design clinical solutions for members who have Medicare and Medicaid. The Lead Product Manager partners across various multi-disciplinary ... our dual members - members that qualify for both Medicare and Medicaid. The Lead Product Manager sits in...extends outside of work. Among our benefits, Humana provides medical , dental and vision benefits, 401(k) retirement savings plan,… more
- Walmart (Orlando, FL)
- …on policy changes and new regulations; researching information to accurately process Medicare orders to ensure compliance ; and interpreting and documenting ... services to patients in accordance with local, state, and federal laws and corporate policies and procedures by assisting...a safe and clean work environment. + Complies with Medicare and Medicaid policies and procedures by implementing and… more
- CenterWell (Callahan, FL)
- …medicine, continuity of care, health maintenance, and disease prevention. Keeps a medical history and medical records. Refers the patient to specialists ... 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
- AdventHealth (Altamonte Springs, FL)
- …patient notifications are provided and documented in a timely manner for compliance : Important Medicare Letters (IML), Medicare Outpatient Observation ... Care coordination, discharge planning, transitions of care planning and understanding of medical necessity are core competencies of this role. The RN Care Manager… more