- 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
- Humana (Tallahassee, FL)
- …other vendors. + Document all calls and requests. + Search for Medicare and Medicaid Guidelines. + Process all incoming fax/emails request for services the same day. ... in special projects as assigned by your Supervisor or Manager . **Use your skills to make an impact** **Required...to help people with Medicare, or both Medicare and Medicaid , achieve their best possible health and wellness through… 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 up on a daily/weekly basis. + This… more
- Elevance Health (Tampa, FL)
- …contracts for Medicare and partner with the Centers for Medicare and Medicaid Services to transform federal health programs. The **Audit and Reimbursement Senior** ... with the federal government (The Centers for Medicare and Medicaid Services (CMS) division of the Department of Health...independently on assignments and under minimal guidance from the manager . + Prepare detailed work papers and present findings… more
- R1 RCM (Jacksonville, FL)
- …to meet their financial obligations. Work with Case Management, Clinical Staff, Medicaid Vendor, and Family Independence Agency to assist patients and families in ... completing assistance program applications and determine eligibility and coverage. Notify manager , physician and servicing department of possible delay of service… more
- CenterWell (Jacksonville, FL)
- …care, primary care or Medicare Advantage settings. + Active DEA license and Medicare/ Medicaid provider numbers or ability to obtain DEA license and/or Medicaid ... largest providers of home health services, and fourth largest pharmacy benefit manager , CenterWell is focused on whole-person health by addressing the physical,… more
- ChenMed (St. Petersburg, FL)
- …social needs and resources available in community resource database. ** Medicaid and other benefit eligibility assessments:** + Conducts appropriate assessment ... of needs and financial benefit eligibility. + Assesses patients for Medicaid criteria and assists with application process as needed. + Assists patients to obtain… more
- Organon & Co. (Orlando, FL)
- …Assignment of Benefits (AOB) and 340B. Knowledge of Managed Care, State Medicaid , Managed Medicaid , Kaiser, Management Service Organizations, Group Purchasing ... and could involve some overnights. + This position reports to the Regional Manager . **Who We Are:** Organon delivers ingenious health solutions that enable people to… 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
- 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 ... children, adolescents, and adults. Note: As an employer receiving Medicare and Medicaid funds, Aveanna employees must comply with all health-related requirements in… more