- Humana (Alachua, FL)
- …community and help us put health first** The Medical Record Retrieval Specialist (Risk Adjustment Representative 3) Travels to provider offices within the region ... are leading to a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at large. **Equal… more
- Aveanna Healthcare (Stuart, FL)
- Home Health RN Traveling Clinical Management Specialist ApplyRefer a FriendBack Job Details Requisition #: 208444 Location: Stuart, FL 34994 Category: Nursing ... regional offices will be required As an employer accepting Medicare and Medicaid funds, employees must comply with all health-related requirements in all relevant… more
- Intermountain Health (Tallahassee, FL)
- …payer re-credentialing requests and demographic/roster requests. + Completes out-of-State Medicaid individual and facility enrollments timely and accurately for ... all aspects of provider enrollment with commercial and government (Medicare and Medicaid ) professional fee payer contracts for an entire market. Ensures enrollment… more
- Healthfirst (FL)
- …and grievances to determine eligibility for dismissal based on Medicaid and Medicare guidelines, including timeliness, completeness, and procedural requirements** ... + **Draft and issue outreach and dismissal letters that are clear, concise, member-friendly, and compliant with applicable regulatory standards and timeframes ie, NYS DOH, CMS** + **Meet or exceed established productivity and quality metrics** + **Communicate… more
- Wellpath (West Palm Beach, FL)
- …agency knowledge including The Joint Commission, DHSS, Centers for Medicaid /Medicare Services is preferred. Licenses/Certifications + Current licensure as a ... Registered Nurse within the state of employment. **We are an Equal Employment Opportunity Employer** We are committed to fostering, cultivating, and preserving a culture of uniqueness. We celebrate a variety of backgrounds and are committed to creating an… more
- MyFlorida (Tallahassee, FL)
- …in this position is expected to report to work daily and on time. The Florida Medicaid program is one of the five largest in the country with an estimated $38 ... billion annual budget. Each month Florida Medicaid covers medical services for over 5 million recipients....in/out SunPass Transponders as needed. Assisting the Management Review Specialist maintaining bureau personnel files for current and former… more
- MyFlorida (Miami, 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)
- …with the National Committee for Quality Assurance (NCQA), Centers for Medicare and Medicaid Services (CMS), state Medicaid entity requirements and all other ... groups. + Assists in preparation of documents for Centers for Medicare and Medicaid Services (CMS), state Medicaid , National Committee for Quality Assurance… more
- Community Based Care of Brevard, Inc. (Orlando, FL)
- …serves as a liaison for Adoption, Foster Board, GAP, and as a Medicaid information resource. ESSENTIAL FUNCTIONS: Monitor and supervise information and eligibility ... specialist staff including tasks specific to Dependency, Adoption, and...GAP Monitor, approve and supervise client eligibility activities for Medicaid and Federal Funds Approve placement and payment information… more
- CVS Health (Tallahassee, FL)
- …submit ICD codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) for the purpose of risk adjustment processes are appropriate, accurate, ... auditing. + CPC (Certified Professional Coder) or CCS-P (Certified Coding Specialist -Physician) required. + CRC (Certified Risk Adjustment Coder) + Computer… more