- HCA Healthcare (Pensacola, FL)
- …alert and comp census reports daily. + Work the Medicare 72 hour and Medicaid 24 hour reports to identify Compliance overlapping accounts. + Transfer charges ... to accounts. Communicates any charge related issues to Charge Master Manager /Analyst. + Works all identified insurance requirement edits through the electronic… more
- MyFlorida (Fort Lauderdale, FL)
- …and maintain up to date policies, protocols and procedures to assure compliance with all relevant standards, statutes and administrative code and train staff ... regarding these. Comply with and monitor compliance (when applicable) of the mandatory requirements of section...The incumbent will serve as a Level 4 Budget Manager to include the preparation and monitoring of annual… more
- Actalent (Sunrise, FL)
- …utilization. Working under the general supervision of the Director and/or Manager /Supervisor of Medical Management, and in collaboration with an interdisciplinary ... Director/Physicians for requests outside standard Review Criteria. + Maintain compliance with federal, state guidelines, and contractual requirements. + Obtain… more
- CenterWell (Pompano Beach, FL)
- …food insecurity, navigation of and application for benefits including, Medicaid , HCBS, working to reduce costs associated with prescription medications, ... + Bachelor's Degree in applicable discipline + Familiarity with state Medicaid guidelines and application processes + Experience working with seniors' complex… more
- Aveanna Healthcare (West Palm Beach, FL)
- …- $70,000.00 per year Position Details Position: Clinical Supervisor (RN) Clinical Case Manager Join a Company That Puts People First! Aveanna Healthcare is one of ... + Collaborate with the operations and business development team. + Ensure compliance with State, Federal, Local, and Aveanna policies and procedures. Qualifications… more
- Convey Health Solutions (Fort Lauderdale, FL)
- …disenrollment forms for correction and submission to Centers for Medicare & Medicaid Services (CMS) + Review and complete Late Enrollment Penalty (LEP) Attestations ... Monthly Reconciliation queues + Daily and Monthly Pharmacy Benefit Manager (PBM) + Monthly MMR, PWR, LIS History and...Functions + Working understanding of Centers for Medicare & Medicaid Services (CMS) guidance + Conform with and abide… more
- Molina Healthcare (FL)
- …intervention initiatives including all lines of business (Medicare, Marketplace, Medicaid ). Executes health plan's member and community quality focused interventions ... to identify opportunities for improvement + Surfaces to the Manager and Director any gaps in processes that may...+ 1 year of experience in Medicare and in Medicaid managed care + Experience with data reporting, analysis,… more
- CHS (Clearwater, FL)
- …claims and customer service calls to ensure validity, accuracy, and compliance with appropriate policies, procedures, and regulations + **Health, Dental, Vision, ... customer service calls within the MPS call center. + Ensures compliance with appropriate company policies, procedures, guidelines, and reporting requirements;… more
- Evolent (Tallahassee, FL)
- …to find the most valuable defects. The IQA reports to a associate director or a manager . One or many IQAs may be engaged in any testing effort **What You Will Be ... + Responsible to escalate risks and issues in coordination with the lead / manager for status reporting + Responsible to enforce department standards as directed by… more
- HCA Healthcare (Gainesville, FL)
- …processes and staffing issues to the Patient Access Supervisor or Patient Access Manager . You will also provide assistance to staff level employees as necessary to ... ensure compliance with department policies and procedures. Assist leadership with...problem-solving + Assists in resolving patient concerns + Assists Manager and/or Supervisor in creating staff schedules and ensures… more