- ChenMed (Miami, FL)
- …prioritize opportunities, and spot trends + Extensive knowledge of healthcare / medical economics data such as hospital/physician /ASC claims , utilization ... and execution of actions to improve those results). + Prepares ad-hoc analysis for claims and KPIs of medical costs for executive leadership + Develops a… more
- Elevance Health (Tampa, FL)
- …Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical -expense spending. The **Investigator II** will be responsible for the ... identification, investigation and development of cases against perpetrators of healthcare fraud in order to recover corporate and client...to recover corporate and client funds paid on fraudulent claims . **How you will make an impact:** + Claim… more
- Elevance Health (Tampa, FL)
- …Integrity, is determined to recover, eliminate and prevent unnecessary medical -expense spending. The **Investigator Senior** is responsible for the independent ... identification, investigation and development of complex cases against perpetrators of healthcare fraud in order to recover corporate and client funds paid on… more
- Elevance Health (Miami, FL)
- …complex audits. + Participates in pre and post implementation audits of providers, claims processing and payment, benefit coding , member and provider inquiries, ... billing, claims and/or customer contact automated environment (preferably in healthcare or insurance sector), including a minimum of 1 year related experience… more
- Elevance Health (Miami, FL)
- …by law._ The Provider Reimburse Admin Sr ensures accurate adjudication of claims , by translating medical policies, reimbursement policies, and clinical editing ... of education and experience, which would provide an equivalent background. + RN; Medical billing and coding certification strongly preferred. Please be advised… more
- Option Care Health (Tallahassee, FL)
- … medical necessity. The specialist must have a solid understanding of basic medical coding , diagnosis codes, and medical terminology. Strong attention to ... system + Obtain and review clinical documentation to verify medical necessity + Communicate with healthcare providers...compliance with payer requirements and regulations + Utilize basic medical coding , diagnosis codes, and medical… more
- Danaher Corporation (Orlando, FL)
- …/ customer facing role responsible for delivering compliant payer coverage, coding and reimbursement information regarding Cepheid on market diagnostics. This role ... will have the opportunity to: + Provide education to internal colleagues, healthcare providers, lab professionals, office staff and financial decision makers on… more
- LogixHealth (Dania Beach, FL)
- …revenue cycle management services, offering a complete range of solutions, including coding and claims management and the latest business intelligence reporting ... site, and aliment information for MVA, WC, MD, insurances + Review claims reports and validations; make all corrections to insurance, patient registrations +… more
- Cognizant (Tallahassee, FL)
- …to be considered: *High school diploma or GED *Proven experience working in healthcare revenue cycle with specializing in hospital claims . *Expertise in ... you will perform advanced level work related to resolution of hospital claims . You will be responsible for resolving aged hospital accounts receivables, identifying… more
- AdventHealth (Orlando, FL)
- …Financial Services, Patient Access, AHS Managed Care departments and applicable medical staff of specific updates, statistical trending and/or changes related to ... PA role is responsible for providing physician review of utilization, claims management, and quality assurance related to inpatient care, outpatient care/observation… more