• Investigator

    Highmark Health (Tallahassee, FL)
    …to testify in a court of law, prepare cases for referral to various federal , state and local law enforcement entities and work with those agencies through closure ... to prevent further improper payments.Forwards case to the Credentialing and/or Medical Review Committee, law enforcement and regulatory agencies. + Responsible for… more
    Highmark Health (05/08/25)
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  • Physician - CenterWell

    CenterWell (Apopka, 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
    CenterWell (06/03/25)
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  • Sales Specialist, Diagnostic Oncology (Central…

    Fujifilm (Tallahassee, FL)
    …with Key Accounts and Opinion Leaders within the Liver/Hepatology Medical Oncology community. Manage specific assigned geographic areas and successfully ... Liaise with office and laboratory staff to provide reimbursement support and test coding . + Development of business plans aligned to strategic accounts with resource… more
    Fujifilm (05/15/25)
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  • Fraud and Waste Investigator

    Humana (Tallahassee, FL)
    …minimum of 2 years' experience conducting comprehensive health care fraud investigations ( Medical Coding or Healthcare ( Medical Chart Review/Insurance ... Claims Investigations or Criminal Investigation/White Collar Crime); interacting with state, federal and local law enforcement agencies. * Ability to work… more
    Humana (06/06/25)
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  • Behavioral Health Liaison

    CVS Health (Tallahassee, FL)
    …coordinated services. - Support record collection and review of case and medical records for behavioral health quality activities, including root cause analysis of ... education to network providers to improve adherence to HEDIS standards of care and coding . - Accurately applies review requirements to assure case is reviewed by a… more
    CVS Health (06/05/25)
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  • Clinical Pharmacy Technician Sr

    Prime Therapeutics (Tallahassee, FL)
    …injectable prescription drugs, disease states, health plan formulary management techniques, medical terminology and current diagnostic and reimbursement coding ... for medications. Communicates decision to physicians, physician`s office staff, medical management staff and/or pharmacists. Researches, resolves and documents prior… more
    Prime Therapeutics (05/29/25)
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  • Patient Access Specialist - Specialty Pharmacy

    AssistRx (Maitland, FL)
    …Access Specialist will support the healthcare providers addressing questions regarding coding and billing and navigating complex reimbursement issues. This position ... patients Requirements + In-depth understanding and experience with Major Medical & Pharmacy Benefit Coverage + 2 to 3...based factors, or any other protected categories protected by federal , state, or local laws. All offers of employment… more
    AssistRx (05/29/25)
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  • Nurse Practitioner ( Full or Part Time )

    Lake Erie College of Osteopathic Medicine (Englewood, FL)
    …+ Must adhere to the ANA code of ethics/guidelines; + Knowledge of general medical coding and related information in the field; + Compliance with State ... TASKS AND RESPONSIBILITIES : + Promotes and maintains patient health by providing medical services under the supervision of a licensed physician; + Contributes to a… more
    Lake Erie College of Osteopathic Medicine (05/24/25)
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  • Director Operations Physical Enterprise

    AdventHealth (Tampa, FL)
    …management related to healthcare operations . Proficient experience in compliant coding guidelines, reimbursement procedures, medical records management and ... Pinellas and Marion Counties **The community you'll be caring for** **:** AdventHealth Medical Group West Florida . Rollover PDO with service year increases in… more
    AdventHealth (06/06/25)
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  • NP/PA Primary Care

    CenterWell (Kissimmee, 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 ... limited to specialty referrals, hospital and SNF coordination, durable medical equipment and home health care. + Acts as...manner working with a quality- based coder to optimize coding specificity. + Follows policy and protocol defined by… more
    CenterWell (06/03/25)
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