- City of Boca Raton (Boca Raton, FL)
- …legal advice to City departments, elected officials, advisory boards, and staff to support lawful, effective, and transparent municipal governance. + Drafts, ... City in civil litigation, administrative hearings, quasi-judicial proceedings, and appeals ; responsibilities include case evaluation, discovery, trial preparation, settlement… more
- Evolent (Tallahassee, FL)
- …care aligned with clinical guidelines. + Collaborate with leadership, management, and clinical staff to address complex cases and support decision-making. + Act as a ... practices. + Provides clinical rationale for standard and expedited appeals . + Discusses determinations (peer to peer phone calls)...+ Ensures documentation of all communications with medical office staff and/or MD provider is recorded in a timely… more
- Amgen (Tampa, FL)
- …patients + Initiating benefits verification by reviewing patient data and insurance material, including identifying missing information and following up with points ... requirements + As applicable, initiating subsequent actions (eg prior authorizations, appeals , travel and appointments) + Monitoring potential delays or pended… more
- Highmark Health (Tallahassee, FL)
- …could be a result of internal/external audits, member/provider phone calls, other insurance information received, appeals , and system changes, etc.; provides ... ensuring timeliness and accuracy of all work given by support staff /management. Maintains accurate records, including timekeeping records and attends all required… more
- MyFlorida (Tallahassee, FL)
- …Communicates with other attorneys, assistants, and clients about hearings, trials, and appeals . Makes note of relevant documents that are delivered to agency clerk, ... be informed. Performs other duties as assigned including assisting other support staff and other attorneys. Florida Department of Health Mission, Vision, and Values:… more
- MyFlorida (Bartow, FL)
- …+ Ability to establish and maintain effective working relationships with members of the staff and the appellate courts + Skilled in determining the proper course of ... and one Personal Holiday each year + State Group Insurance coverage options, including health, life, dental, vision, and...to protecting the rights of the accused in criminal appeals . If you are an appellate lawyer who is… more
- Elevance Health (Vero Beach, FL)
- …+ May also serve as mentor, subject matter expert or preceptor for new staff , assisting in the formal training of associates, and may be involved in process ... + Assists and participates in appeal or fair hearings, member grievances, appeals , and state audits. **Minimum Requirements:** + Requires BA/BS degree and a… more
- TEKsystems (Orlando, FL)
- …all ASC encounters to meet billing deadlines. * Collaborate with clinical staff , providers, and revenue cycle teams to clarify documentation or resolve ... trends, coding errors, or compliance risks. * Assist with appeals and denials related to coding or medical necessity....- Pre-tax and Roth post-tax contributions available * Life Insurance (Voluntary Life & AD&D for the employee and… more
- Elevance Health (Miami, FL)
- …May identify cost of care opportunities. May serve as a resource to staff including Medical Director Associates. May be responsible for an entire clinical program. ... a state or territory of the United States when conducting utilization review or an appeals consideration and cannot be located on a US military base, vessel or any… more
- Elevance Health (Miami, FL)
- …Associate Medical Director** is responsible for supporting the medical management staff ensuring timely and consistent medical decisions to members and providers. ... for services requested. + Makes medical necessity determinations for grievance and appeals appropriate for their specialty. + Ensures consistent use of medical… more