- MyFlorida (Key West, FL)
- …judgments, post-conviction orders, memoranda or orders concerning extraordinary writs; + Review motions for post-conviction relief brought pursuant to Florida Rule ... criminal, family, and probate divisions, and the county civil, criminal, and small claims divisions; + Perform other related duties as required; + Drafts proposed… more
- Actalent (Boca Raton, FL)
- …personalized home exercise programs that align with treatment goals. + Regularly update medical timelines and patient plan of care cards. + Review and ... and address concerns. + Write and send detailed progress updates to assigned medical doctors, engaging in discussions to optimize patient care. + Assist with general… more
- Humana (Tallahassee, FL)
- …time frame. + CAS, MedHOK experience strongly preferred + Previous experience processing medical claims **Required Work Schedule** **This is a remote role and ... issues. manages client denials and concerns by conducting a comprehensive analytic review of clinical documentation to determine if an a grievance, appeal or… more
- Point32Health (FL)
- …and Federal regulatory requirements + Manage the collection of documents and records ( medical , claims , administrative) needed to fully research the appeal or ... skills in all interactions. This individual prepares cases for presentation, discussion, review , and final disposition at the Member Appeals Committee (MAC) and… more
- CVS Health (Tallahassee, FL)
- …with resolution of problems involving research into policy, data, or claims . Identifies, researches, develops, and recommends solutions to problems/issues. - ... with the Job Summary **Required Qualifications** 6 months minimum experience with clinical review - Proficiency in Aetna Systems utilized in CCR - Rumba, ASD,… more
- Jacobs (Fort Lauderdale, FL)
- …* Aligned PM Performance * Operational governance, process adherence and quality * Claims against the company * New sales opportunities KEY ROLES & RESPONSIBILITIES ... reserves. Engages Management, Program Director(s), legal, contracts and compliance in the review and approval process * Works with operational sales and CAMS for… more
- CVS Health (Tallahassee, FL)
- …Monitor service performance and implement improvements, as necessary. Gain in-depth knowledge of claims system and Call Tracking System to be able to lookup and ... in daily/weekly/monthly operational calls with client and internal operations to review and calibrate client service metrics and performance guarantees. Analyze data… more
- Intermountain Health (Tallahassee, FL)
- …Integrity (CDI) Registered Nurses (RN) and Intermountain Physician Advisors to review complex facility encounters and assign International Classification of Diseases ... ICD-10 and Diagnosis Related Groups (DRG) codes for claims concurrently while a patient is in a hospital....reviews while patients are hospitalized. It aids in the review of quality measures including Patient Safety Indicators and… more
- HCA Healthcare (Miami, FL)
- …and retirement of our colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no cost or for a low ... as well as free telemedicine services and free AirMed medical transportation. + Additional options for dental and vision...necessary (eg, combining the codes for outpatient and inpatient claims subject to the payment window) + Assist the… more
- AdventHealth (Altamonte Springs, FL)
- …Cerner and 3M Encoder 4. Comfortable with all Microsoft Office programs. 5. Ability to review documentation in a medical record and to enter the coding software. ... Team of any coding or coding related issues that adversely impact the claims processing, coding accuracy, and compliance.e. Monitors the queue holds and adhere to… more