- CenterWell (Daytona Beach, FL)
- …for TB **Preferred Qualifications** + Active and unrestricted DEA license + Medicare Provider Number/ Medicaid Provider Number + Experience managing Medicare ... coordinated care environment in a value-based relationship environment + Knowledge of Medicare guidelines and coverage + Knowledge of HEDIS quality indicators +… more
- Humana (Miramar, FL)
- …of applicable CPT, HCPC, ICD-10 codes, and all insurance contracts. Understand Medicare /Medicaid criteria and Health Plan policies to ensure the referral meets all ... issues with referring entities or providers that delay service delivery to manager . Provides excellent internal and external customer service by ensuring work meets… more
- Elevance Health (Tampa, FL)
- …specific understanding in end-to-end claims/ encounter processing, as well as ensuring compliance with Medicare / Medicaid regulatory policies regarding FFS and ... Requires experience using RADV protocols and following Center for Medicare and Medicaid Services (CMS) and Affordable Care Act...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
- HCA Healthcare (Pensacola, FL)
- …to accounts. Communicates any charge related issues to Charge Master Manager /Analyst. + Works all identified insurance requirement edits through the electronic ... billing system + Communicates issues with department manager . + Researches required information and maintains pending follow...alert and comp census reports daily. + Work the Medicare 72 hour and Medicaid 24 hour reports to… more
- HCA Healthcare (Kissimmee, FL)
- …management assistant (CMA) will work under the direction of the RN case manager or social worker to assist with facilitating patient discharges requiring post-acute ... administrative support in Case Management functions. + Coordinates with RN case manager and social worker for support needed. Communicates updates on progress… more
- Trinity Health (Fort Lauderdale, FL)
- …work of assigned staff including the monitoring of competencies. Develops with manager goals and objectives, conducts annual performance appraisals with manager ... goals, and other trends that drive key performance metrics.** **Assists manager with recruitment and hiring. Responsible for orientation, training and coaching… more
- HCA Healthcare (Fort Walton Beach, FL)
- …management assistant (CMA) will work under the direction of the RN case manager or social worker to assist with facilitating patient discharges requiring post-acute ... do in this role: + Coordinates with RN case manager and social worker for support needed. Communicates updates...including having the Patient Choice letter signed. + Monitors Medicare patient's planned discharge dates and delivers the Important… more
- AdventHealth (Altamonte Springs, FL)
- …allied health practitioners, nursing, and care management. This includes quarterly compliance updates from Medicare . + Effectively and appropriately communicates ... will contribute:** Under general supervision of the Clinical Documentation Integrity (CDI) Manager , and in some situations the supervision of the Director of… more
- CenterWell (Tallahassee, FL)
- …delivery of associate-facing contact center technologies that support Pharmacy and Medicare Part D operations. This enterprise-wide platform empowers associates to ... a related field. **Preferred Qualifications:** + Understanding of pharmacy operations and Medicare Part D. + Experience with contact center platforms and CRM… more
- CenterWell (Palm Coast, FL)
- …local primary care "on-call" program of Conviva as needed. . Assures personal compliance with licensing, certification, and accrediting bodies. . Spend 100% of your ... two to five years directly applicable experience preferred . Experience managing Medicare Advantage panel of patients with understanding of Best Practice in… more