- AdventHealth (Maitland, FL)
- …Verifies medical necessity in accordance with Centers for Medicare & Medicaid Services (CMS) standards by reviewing guidelines and communicates relevant ... coverage/eligibility information to the patient. Alerts physician offices to issues with verifying insurance. Responsible for communicating to service line partners of situations where medical necessity is not met to include review of journal articles,… more
- Molina Healthcare (Jacksonville, FL)
- …Experience: * 4-years' experience in Credentialing. * Required knowledge of Medicaid , CMS, NCQA and other credentialing regulations. * Experience leading employees, ... preferably in a production-related role. * Demonstrated adaptability and flexibility to changes and response to new ideas and approaches. * Strong problem-solving skills including root cause analysis and prompt resolution. * Excellent interpersonal and… more
- HCA Healthcare (Orange Park, FL)
- …full-service revenue cycle management as well as targeted solutions, such as Medicaid Eligibility, for external clients across the country. Parallon has over 17,000 ... colleagues, and serves close to 1,000 hospitals and 3,000 physician practices, all making an impact on patients, providers and their communities. HCA Healthcare has been recognized as one of the World's Most Ethical Companies(R) by the Ethisphere Institute… more
- Molina Healthcare (FL)
- …familiarity with various managed healthcare provider compensation methodologies, primarily across Medicaid and Medicare lines of business, including but not limited ... to; fee-for service, capitation, and various forms of risk, ASO, etc. **Preferred Education** Bachelor's or master's degree. **Preferred Experience** + 5+ years' experience in managed healthcare administration and/or Provider Services. + 5+ years' experience… more
- Molina Healthcare (Jacksonville, FL)
- …experience is required + Previous dental, case management, pediatric, and/or Medicaid managed care experience is preferred **Required Competencies / Knowledge / ... Skills** : + Compassion to serve people and make a difference in people's lives + Typing a minimum of 35wpm proficiently + Ability to talk and data enter simultaneously + Intermediate proficiency level with Microsoft Office products, including Word and Excel +… more
- HCA Healthcare (Gainesville, FL)
- …full-service revenue cycle management as well as targeted solutions, such as Medicaid Eligibility, for external clients across the country. Parallon has over 17,000 ... colleagues, and serves close to 1,000 hospitals and 3,000 physician practices, all making an impact on patients, providers and their communities. HCA Healthcare has been recognized as one of the World's Most Ethical Companies(R) by the Ethisphere Institute… more
- Aveanna Healthcare (Sebastian, FL)
- …practice * Current CPR certification As an employer accepting Medicare and Medicaid funds, employees must comply with all health-related requirements in all relevant ... jurisdictions, including required vaccinations and testing, subject to exemptions for medical or religious reasons as appropriate. Notice for Job Applicants Residing in California (https://www.aveanna.com/CaliforniaPrivacyNotices.html) Apply more
- Aveanna Healthcare (Ocoee, FL)
- …+ Basic understanding of OASIS As an employer accepting Medicare and Medicaid funds, employees must comply with all health-related requirements in all relevant ... jurisdictions, including required vaccinations and testing, subject to exemptions for medical or religious reasons as appropriate. Notice for Job Applicants Residing in California (https://www.aveanna.com/CaliforniaPrivacyNotices.html) Apply more
- HCA Healthcare (Ocala, FL)
- …full-service revenue cycle management as well as targeted solutions, such as Medicaid Eligibility, for external clients across the country. Parallon has over 17,000 ... colleagues, and serves close to 1,000 hospitals and 3,000 physician practices, all making an impact on patients, providers, and their communities. HCA Healthcare has been recognized as one of the World's Most Ethical Companies(R) by the Ethisphere Institute… more
- Lundbeck (Miami, FL)
- …and effectively address payer access issues (IDNs, Medicare, Medicaid , Commercial) using Lundbeck resources. **Pharmaceutical Environment/Compliance** - Ability ... to apply knowledge of pharmaceutical and regulatory environment, including accountability and adherence to Lundbeck policies and procedures and FDA regulations regarding the promotion of pharmaceutical and medical products. **REQUIRED EDUCATION, EXPERIENCE and… more