- Molina Healthcare (Tampa, FL)
- …be licensed for the state they reside This position will support Medical Review for Medicare and Marketplace request authorization. Strongly prefer candidates with ... appropriate and correct clinical decisions for appeals outcomes within compliance standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse (RN)… more
- CenterWell (Deerfield Beach, FL)
- …Doctors, Advanced Practice professionals, Pharm D, Care Coach Nurses, Medical Assistants, Behavioral Health, Specialists, Quality Based Coders, Referral Coordinators ... accordance with standards of care. . Follows level of medical care and quality for patients and monitors care...manner working with a quality- based coder to optimize coding specificity. . Follows policy and protocol defined by… more
- HCA Healthcare (Orange Park, 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...+ Performs timely abstraction of assigned cases to ensure compliance with ACOS standards ,i.e. within six months of… more
- CenterWell (Tallahassee, FL)
- …treats center patients in accordance with standards of care. + Follows level of medical care and quality for patients and monitors care using available data and ... the care team through daily huddles. + Helps Associate Medical Director (AMD), Physician and Center Administrator in setting...manner working with a quality- based coder to optimize coding specificity. + Follows policy and protocol defined by… more
- AssistRx (Orlando, FL)
- …Access Specialist will support the healthcare providers addressing questions regarding coding and billing and navigating complex reimbursement issues. This position ... Ensure cases move through the process as required in compliance with company requirements and the organization's defined standards...Access Specialist: + In-depth understanding and experience with Major Medical & Pharmacy Benefit Coverage + 2 to 3… more
- HCA Healthcare (Largo, 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...+ Performs timely abstraction of assigned cases to ensure compliance with ACOS standards, ie within six months of… more
- R1 RCM (Pensacola, FL)
- …transform the patient experience and financial performance of hospitals, health systems and medical groups. We are the one company that combines the deep expertise ... record deficiency completion as it relates to patient care, regulatory, compliance , legal and reimbursement activities, as well as birth certification completion… more
- Humana (Tallahassee, FL)
- …minimum of 2 years' experience conducting comprehensive health care fraud investigations ( Medical Coding or Healthcare ( Medical Chart Review/Insurance ... extends outside of work. Among our benefits, Humana provides medical , dental and vision benefits, 401(k) retirement savings plan,...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
- AssistRx (Orlando, FL)
- …Access Specialist will support the healthcare providers addressing questions regarding coding and billing and navigating complex reimbursement issues. This position ... Ensure cases move through the process as required in compliance with company requirements and the organization's defined standards...etc. Requirements + In-depth understanding and experience with Major Medical & Pharmacy Benefit Coverage + 2 to 3… more
- USAA (Tampa, FL)
- …the health insurance industry, Medicare or Medicare Supplement preferred. + Proficient knowledge of medical claims coding ICD-10, CPT, HCPC, EDI 837, etc. + CFE, ... interviews, searches of investigative databases, internal resources, internet resources, medical records, law enforcement records, and/or public records to support… more