- AssistRx (Maitland, FL)
- We are in search for a Compliance Specialist . Compliance works to ensure controls and safeguards are in place to promote adherence to applicable federal and state ... of third-party audits. + Verifies compliance with insurer rules, Medicare, Medicaid , HIPAA, and other applicable regulations. + Assists in Incident Management… more
- Butterfly Effects (Deerfield Beach, FL)
- …team that makes a difference! Butterfly Effects is looking for a Medical Billing Specialist to support our national billing needs. In this role, you'll ensure clean ... School Diploma or GED required. + 1-2 years of medical billing experience ( Medicaid and commercial insurance preferred). + Basic Excel knowledge for data management… more
- Molina Healthcare (Tampa, FL)
- …and requirements established by the Centers for Medicare and Medicaid **KNOWLEDGE/SKILLS/ABILITIES** + Responsible for the comprehensive research and resolution ... coordination of benefits, subrogation, and eligibility criteria. + Familiarity with Medicaid and Medicare claims denials and appeals processing, and knowledge of… more
- Molina Healthcare (Jacksonville, FL)
- …and have a high level of customer service. Previous experience in Medicare, Medicaid , and/or Managed Care is very helpful. Top notch communication skills, both ... written and verbal are essential. Experience using Genesys and/or Sales Force software is a plus! Bilingual in Mandarin or Cantonese needed! **Job Summary** Responsible for continuous quality improvements regarding member engagement and member retention.… more
- Cardinal Health (Tallahassee, FL)
- …+ Cell/Gene therapy and/or Oncology experience, preferred + Knowledge of Medicare, Medicaid and Commercially insured payer common practices and policies, preferred + ... Knowledge of the Health Insurance Market Place and the Affordable Care Act preferred + Knowledge of ICD9/ICD10 coding is preferred + Critical and creative thinking, preferred + Important to have a strong attention to detail **TRAINING AND WORK SCHEDULES:**… more
- Wider Circle (Daytona Beach, FL)
- …phone or video conferencing. + A genuine interest in working with Medicare/DSNP/ Medicaid populations and a commitment to building strong, supportive relationships. + ... Strong verbal and written communication skills to effectively engage with diverse community members. + Proactive approach to outreach, with the ability to take lead on community engagement initiatives. + Adaptability to a dynamic work environment and a… more
- MyFlorida (Fort Lauderdale, FL)
- …AGENCY FOR PERSONS WITH DISABILITIES POSITION: HUMAN SERVICES PROGRAM SPECIALIST - Career Service WORKING TITLE: PROVIDER ENROLLMENT COORDINATOR POSITION ... and maintenance of iBudget waiver applicants; issuance and renewal of Medicaid Waiver Service Agreements (MWSA), processing provider expansion requests, and… more
- Molina Healthcare (Tampa, FL)
- …Assists and executes tasks and projects to ensure Centers for Medicare & Medicaid Services (CMS) and State regulatory requirements are met for Pre-pay Edits, ... Care Organization (MCO) or health plan setting, including experience in Medicaid and/or Medicare, or equivalent combination of relevant education and experience… 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...department are achieved. + Works with Quality and Training specialist to refine and improve any processes that effect… 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