- Elevance Health (Miami, FL)
- … claims , by translating medical policies, reimbursement policies, and clinical editing policies into effective and accurate reimbursement criteria.** PRIMARY ... DUTIES: + Review medical record documentation in support of Evaluation and...reimbursement policies, and editing rules, as well as conducts clinical research, data analysis, and identification of legislative mandates… more
- Elevance Health (Miami, FL)
- **Telephonic Nurse Case Manager II** **Sign On Bonus: $3000** **Location** : This role enables associates to work virtually full-time, with the exception of required ... states; therefore Multi-State Licensure will be required.** The **Telephonic Nurse Case Manager II** is responsible for performing care management within the scope… more
- Elevance Health (Altamonte Springs, FL)
- …of service that's easy and focused on whole health. Through our distinct clinical expertise, digital capabilities, and broad access to specialty medications across a ... and Collection Specialist** is responsible for collection activities related health insurance claims and patient balances. **How You Will Make an Impact** Primary… more
- HCA Healthcare (Sarasota, FL)
- …collections for patient services. Under the supervision of the Business Office Manager /Business Office Supervisor, you will obtain payment from third party payers ... work to correct them + You will monitor insurance claims and contact insurance companies to resolve claims...network. We do so with the backing of the clinical , operational, and financial expertise of a Fortune 100… more
- Elevance Health (FL)
- …outpatient precertification, prior authorization, and post service requests. + Refers cases requiring clinical review to a Nurse reviewer. + Responsible for the ... I** is responsible for coordinating cases for precertification and prior authorization review . **How will you make an impact:** + Managing incoming calls or… more
- AdventHealth (Altamonte Springs, FL)
- …Coding programs. Will work with Case Management, the Billing Office, Coding Manager , Clinical Documentation Improvement specialists and the coding team to ... Team of any coding or coding related issues that adversely impact the claims processing, coding accuracy, and compliance.e. Monitors the queue holds and adhere to… more
- LogixHealth (Dania, FL)
- …contribute to our fast-paced, collaborative environment and bring your expertise to review reimbursements and issues in Carrier Payment Audits. The ideal candidate ... skills, excellent interpersonal communication, and analytical skills. Key Responsibilities: + Review all insurance company reimbursements in all practices for all… more
- NHS Management, LLC (Tallahassee, FL)
- …the residents at all times. PRIMARY FUNCTIONS 1. Work with Regional Case Manager regarding coverage and services to meet resident's needs. 2. Conducts compliance ... areas that need improvements or change. 3. Eliminate/reduce resident liability claims through use of corporate policies and established customer service program.… more
- Trinity Health (Fort Lauderdale, FL)
- …coding team for simple and/or complex coding; monitors charge router, charge review , and claim edit WQs; identify appropriate ICD-10, CPT, HCC, HCPCS, and ... work of assigned staff including the monitoring of competencies. Develops with manager goals and objectives, conducts annual performance appraisals with manager … more
- HCA Healthcare (Trinity, FL)
- …members on analysis of risk assessment, historical and concurrent occurrence and claims data and national trends. .You will ensure responsibility for organizational ... licensure as a Registered Nurse preferred _**If serving as facility's primary Risk Manager , VP must have current Florida license in Healthcare Risk Management (FL… more