- Cognizant (Tallahassee, FL)
- …based on the review of clinical documentation in accordance with Medicare , Medicaid, and third-party guidelines. . Effectively document and log claims/appeals ... Reviews can be based on InterQual, Milliman Clinical Guidelines (MCG), Medicare guidelines, and health insurer specific guidelines. . Review retro-authorizations in… more
- Aveanna Healthcare (Melbourne, FL)
- …active LPN License in the state of application + Valid CPR Preferred: + Medicare Skilled Nursing experience + Basic understanding of Oasis + 1-year LPN experience in ... setting + Home Care Home Base exp a plus As an employer accepting Medicare and Medicaid funds, employees must comply with all health-related requirements in all… more
- Aveanna Healthcare (Brooksville, FL)
- …active RN License in the state of application + Valid CPR Preferred: + Medicare Skilled Nursing experience + Basic understanding of Oasis + 1-year RN experience in ... a health care setting As an employer accepting Medicare and Medicaid funds, employees must comply with all health-related requirements in all relevant jurisdictions,… more
- CenterWell (Tallahassee, FL)
- …and monitoring the Tele Sales Agents who are responsible for converting Medicare eligible callers to patients. The Care Delivery Call Quality Professional is ... quality auditing experience + Understanding of value-based primary care and/or Medicare Advantage + Familiarity with healthcare systems and patient satisfaction… more
- Aveanna Healthcare (West Palm Beach, FL)
- …in the state of application * Valid CPR and Drivers License Preferred: * Medicare Skilled Nursing experience * Basic understanding of Oasis * 1-year RN experience in ... a health care setting As an employer accepting Medicare and Medicaid funds, employees must comply with all health-related requirements in all relevant jurisdictions,… more
- DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
- …by management Qualifications: + Minimum of 5 years of FWA, healthcare and/or Medicare Advantage experience + Strong knowledge of Medicare Advantage, CMS and ... AHCA regulatory requirements + Expertise in FWA, Special Investigations and claims processing + Outstanding research and investigative skills + Proven track record in operations and process improvement + Able to thrive in a complex, high-pressure environment +… more
- Aveanna Healthcare (Port Saint Lucie, FL)
- …in the state of application + Valid CPR and Drivers License Preferred: + Medicare Skilled Nursing experience + Basic understanding of Oasis + 1-year LPN experience ... setting + Home Care Home Base exp a plus As an employer accepting Medicare and Medicaid funds, employees must comply with all health-related requirements in all… more
- Insight Global (Jacksonville, FL)
- …Medical Assistant in Lakewood to work at a primary care facility treating 65+ Medicare patients. As a MA you will be responsible for providing the following ... of MA experience * Enjoy working with older patients (Patient Population is 65+ Medicare ). * Very detail oriented * Experience with doing Manual dip urines, blood… more
- Prime Therapeutics (Tallahassee, FL)
- …all provider and member materials and communications, and product ownership for Medicare and Medicaid formularies + Provide consultation and recommendations to the ... experience + Knowledge of the applicable line of business (eg, Medicare , Medicaid, Exchange, Commercial, Employer Group) Every employee must understand, comply… more
- Aveanna Healthcare (Stuart, FL)
- …RN or PT experience in a healthcare setting (home health or hospice) + Medicare Skilled Nursing experience and a basic understanding of OASIS As an employer ... accepting Medicare and Medicaid funds, employees must comply with all health-related requirements in all relevant jurisdictions, including required vaccinations and… more