- Humana (Tallahassee, FL)
- …ensure successful submission and reconciliation of encounter submissions to Medicaid /Medicare. Ensures encounter submissions meet or exceed all compliance standards ... and develops tools to enhance the encounter acceptance rate by Medicaid /Medicare. Looking for long-term improvements of encounter submission processes. Begins to… more
- MyFlorida (Orlando, FL)
- …SNAP (Food Assistance), D-SNAP (Disaster Food Assistance), TANF (Cash Assistance), and Medicaid programs by individuals or merchants. TO BE CONSIDERED FOR THIS ... eligibility for Public Assistance Programs (Temporary Cash Assistance, Food Assistance, Medicaid and Refugee Assistance). PREFERENCE WILL BE GIVEN TO CANDIDATES WITH… more
- Prime Therapeutics (Tallahassee, FL)
- …management. Enforces teamwork across all internal departments, as well as with Medicaid Clients, and an in-depth understanding of all rebate programs, trends, and ... state laws and standards of practice which govern the Medicaid Drug Rebate Program. + Ensures compliance with each...Drug Rebate Program. + Ensures compliance with each State Medicaid contract. + Maintains rebate records in accordance with… more
- Molina Healthcare (St. Petersburg, FL)
- …and processing. This role will focus on identifying, reviewing, and validating Medicaid secondary payments to ensure alignment with internal configuration rules and ... adjudication, QNXT system navigation, and strong analytical acumen. Experience in Medicaid managed care is required, and a background in payment integrity-either… more
- Humana (Hallandale Beach, FL)
- …first? During the period of this unpaid internship, you will work with the Medicaid Clinical Services team to ensure interaction between the company and members are ... Spouse Fellowship, with an opportunity to train and work with Humana's Medicaid Team for the Applied Behavioral Analysis, (ABA) contract requirements. During the… more
- Humana (Tallahassee, FL)
- …matter expert on NCQA Health Plan Accreditation Member Experience (ME) and Medicaid Module (MED) requirements, advising stakeholders on compliance. + Works closely ... + 3+ years of experience in NCQA Health Plan Accreditation and/or Medicaid Module. + Exceptional analytical and critical thinking skills, including problem solving… more
- Humana (Tampa, FL)
- …tracking of all member and marketing communications related to Florida Medicaid . This role manages communications throughout their entire lifecycle, beginning with ... standards of contractual accuracy in alignment with the latest Florida Medicaid contract. This position is responsible for facilitating comprehensive internal and… more
- Community Based Care of Brevard, Inc. (Orlando, FL)
- …and processes client information to determine eligibility for Federal/State funding and Medicaid . In this role you will assist in resolving problems, locating ... Obtains and maintains appropriate eligibility documentation Completes applications for Medicaid and Federal/State Funds SSI applications, tracking and change of… more
- Molina Healthcare (FL)
- …relevant education and experience. + At least 3 years of Experience with Medicaid and/or Medicare. + Proven experience owning operational projects from concept to ... (ICD), Healthcare Common Procedure Coding System (HCPCS), Revenue Codes), and federal/state Medicaid payment rules. + Skilled in Excel and SQL, with the ability… more
- MyFlorida (Tallahassee, FL)
- …(AHCA) is the State of Florida agency responsible for oversight of the Medicaid program. The Medicaid program provides low-income families and individuals with ... Administrative Assistant I position which provides general office support to the Medicaid Fair Hearing Unit. Duties include: data entry, copying, mailing, filing and… more