- The Cigna Group (Tampa, FL)
- …of communication with matrix partners including but not limited to, Claims Operations, Medical Management. Credentialing, Legal, Medical Economics, Compliance, Sales ... or complex provider contracts and alternate contract terms. + Creates healthcare provider agreements that meet internal operational standards and external provider… more
- HCA Healthcare (Miami, FL)
- …Inpatient Coding experience. Are you passionate about the patient experience? At HCA Healthcare , we are committed to caring for patients with purpose and integrity. ... + Employee Stock Purchase Plan with 10% off HCA Healthcare stock + Family support through fertility and family...necessary (eg, combining the codes for outpatient and inpatient claims subject to the payment window) + Assist the… more
- Molina Healthcare (FL)
- …network adequacy and provider training and education, in alignment with Molina Healthcare 's overall mission, core values, and strategic plan and in compliance with ... staff are the primary point of contact between Molina Healthcare and contracted provider network. They are responsible for...2 - 3 years customer service, provider service, or claims experience in a managed care setting. * Working… more
- Molina Healthcare (Miami, FL)
- …and timely validation and maintenance of critical provider information on all claims and provider databases. Staff ensure adherence to business and system ... not limited to, Configuration, Business Systems, Encounters (inbound and outbound), Claims , Provider Services and Contracting. * Identifies issues, resolves problems… more
- HCA Healthcare (Niceville, FL)
- …HCA Florida Twin Cities Hospital our nurses set us apart from any other healthcare provider. We are seeking a(an) RN Infection Prevention and Employee Health to join ... our healthcare family. **Benefits** HCA Florida Twin Cities Hospital, offers...inservices. Ensures the timely processing of employee workers' compensation claims ; evaluates occurrence reports to determine accuracy and completeness.… more
- DOCTORS HEALTHCARE PLANS, INC. (Miami, FL)
- …Improvement initiatives. This role ensures effective care coordination, promotes quality healthcare delivery, manages healthcare costs, and ensures compliance ... with internal stakeholders including the Chief Medical Officer, Provider Relations, Claims , and IT to ensure seamless integration of medical management processes.… more
- LogixHealth (Dania, FL)
- …teams to provide cutting edge solutions that will directly improve the healthcare industry. You'll contribute to our fast-paced, collaborative environment and bring ... offering a complete range of solutions, including coding and claims management and the latest business intelligence reporting dashboards...we have had a clear vision of a better healthcare system and have continually evolved to get there.… more
- Mayo Clinic (Jacksonville, FL)
- …research experience. + Experience working with healthcare services or healthcare delivery data, including administrative claims and EHR data, and ... healthcare quality outcomes research strongly preferred. + Knowledge of hospital quality measures, such as those used in CMS pay-for-performance programs and hospital ratings. **Exemption Status** Exempt **Compensation Detail** $92,242 - $107,910/ year;… more
- DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
- …and credentialing documents are entered and/or scanned into the Doctors HealthCare Plans, Inc, ("DHCP") credentialing CACTUS database, provide data entry and ... School/Residency/Fellowship completion, Hospital privileges verification, System Award Management (SAM), Claims history, Accreditation (ancillary facilities), Site Visits and obtaining… more
- Molina Healthcare (St. Petersburg, FL)
- …medical oversight and expertise in appropriateness and medical necessity of healthcare services provided to members, targeting improvements in efficiency and ... focused reviews and recommends corrective actions. + Conducts retrospective reviews of claims and appeals and resolves grievances related to medical quality of care.… more