- WestCare Foundation (Miami, FL)
- …Reviews + Document all clinical services and activities in accord with licensing, Medicaid , and Joint Commission standards and agency policy and procedure + Review ... clinical records to ensure compliance licensing, Medicaid , and Joint Commission standards and agency policy and procedure. + Provide in-home/on-site individual… more
- AdventHealth (Maitland, FL)
- …research to obtain and maintain non-contracted payer reimbursement including Medicare, Medicaid , Tricare and other govt payers. * Responsible for ensuring accurate ... remaining current on regulatory updates and rate changes that affect Medicare, Medicaid and TriCare reimbursement for contract loading and analysis purposes. *… more
- Devereux Advanced Behavioral Health (Orlando, FL)
- …for new MDs and ARNPs joining MMA plans. + Apply for Florida Medicaid numbers for providers during onboarding. + Complete special projects within designated ... to work independently and manage multiple tasks. + Familiarity with CAQH, Medicaid processes, and insurance credentialing _preferred_ . **Other:** + Valid driver's… more
- J&J Family of Companies (West Palm Beach, FL)
- …and affordability solutions across multiple payer types and plans (ie, Medicare, Medicaid Managed Care, Commercial). + Execute business in accordance with the ... payer approval processes and business acumen. + Understanding of Medicare, Medicaid , and private payer initiatives affecting reimbursement of pharmaceutical and… more
- J&J Family of Companies (Jacksonville, FL)
- …and affordability solutions across multiple payer types and plans (ie, Medicare, Medicaid Managed Care, Commercial). + Execute business in accordance with the ... payer approval processes and business acumen. + Understanding of Medicare, Medicaid , and private payer initiatives affecting reimbursement of pharmaceutical and… more
- Humana (Tallahassee, FL)
- …Guidance on following and reviewing home health, SNF, DME, dual Medicare/ Medicaid and Waiver requests. The Medical Director provides medical interpretation and ... leading to a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at large. **Equal… more
- DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
- …accurately and in a timely manner. + Adheres to Medicare and Medicaid regulatory guidelines as it pertains to patient admission/safe discharge. + Participates ... health diagnoses, treatments, and psychotropic medications + Knowledge of Medicaid , Medicare, and/or commercial insurance policies + Demonstrates commitment to… more
- CVS Health (Tallahassee, FL)
- …the ICD codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) for the purpose of risk adjustment processes are appropriate, accurate, ... (ICD) codes required. + Experience with Medicare and/or Commercial and/or Medicaid Risk Adjustment process and Hierarchical Condition Categories (HCC) required. +… more
- CVS Health (Tallahassee, FL)
- …within Network; Examples include ensuring data standards are synchronized across Medicaid and Medicare platforms, ensuring duals workflows are support across ... experience in strategy and delivery leadership roles + 5+ years of Medicare/ Medicaid and/or Duals experience + Proven success navigating large scale cross functional… more
- Humana (Tallahassee, FL)
- …revenue cycle management (related to billing, coding, collections for Medicare and Medicaid claims) + Experience with Auditing and monitoring of healthcare records + ... are leading to a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at large. **Equal… more