- Cognizant (Tallahassee, FL)
- …and member onboarding for individual, group, and government-sponsored health plans ( Medicare , Medicaid, ACA), ensuring compliance with CMS, ACA, and other regulatory ... sales and enrollment processes for individual, group, and government-sponsored health plans ( Medicare , Medicaid, ACA). . Strong understanding of CMS, ACA, and other… more
- MyFlorida (Naples, FL)
- …clients and representatives from 3rd party insurance companies, Medicaid, and Medicare for the verification of insurance and coverage. Additionally, this position ... not limited to: + Verifies client insurance and coverage to include Medicaid, Medicare , and 3rd party insurances. + Utilizes the FLMMIS system, Change Health,… more
- Molina Healthcare (Orlando, FL)
- …Procedure Coding (HCPC). * Experience demonstrating knowledge of Centers for Medicare and Medicaid Services (CMS) guidelines, MCG, InterQual or other medically ... appropriate clinical guidelines, Medicaid, Medicare , CHIP and Marketplace, applicable state regulatory requirements, including ability to easily access and interpret… more
- MyFlorida (Tallahassee, FL)
- …responsible for analyzing, developing, implementing, coordinating, and/or monitoring contracted Medicare and Medicaid services within the Bureau of Plan Management ... accommodation MINIMUM QUALIFICATIONS REQUIREMENTS One (1) years of Medicaid or Medicare Contract Management experience. One (1) year of experience working with… more
- Humana (Tallahassee, FL)
- …improving consumer experiences **Preferred Qualifications** + Health insurance experience + Medicare Advantage experience Travel: While this is a remote position, ... efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities at large. … more
- Evolent (Tallahassee, FL)
- …current exclusion or sanction by any state or federal health care program, including Medicare or Medicaid, and is not identified as an "excluded person" by the ... Human Services or the General Service Administration (GSA), or reprimanded or sanctioned by Medicare . + No history of a major disciplinary or legal action by a state… more
- Humana (Tallahassee, FL)
- …Coder + Demonstrate ability to problem-solve complex coding issues + Experience with Medicare and Medicaid coding guidelines + Strong data entry and attention to ... efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities at large. … more
- Molina Healthcare (Tampa, FL)
- …compliance with the National Committee for Quality Assurance (NCQA), Centers for Medicare and Medicaid Services (CMS), state Medicaid entity requirements and all ... delegated groups. + Assists in preparation of documents for Centers for Medicare and Medicaid Services (CMS), state Medicaid, National Committee for Quality… more
- University of Miami (Palm Beach Gardens, FL)
- …HIPAA Notice of Privacy, No Surprise Billing, Good Faith Estimate, Off Campus Medicare Co-insurance and Advance Beneficiary Notices, and Medicare Secondary Payer ... Questionnaire. + Serves as gatekeeper, performs insurance verification, and obtains referrals and/or authorizations as needed. + Provides financial counseling services at check-in, explains benefits, creates estimates, and notifies patients of self-pay… more
- Gentiva (Winter Garden, FL)
- …operations, ensuring compliance with state, federal, and accreditation standards (CMS, Medicare , Joint Commission, etc.) + Provide clinical oversight and ensure ... operations leadership + Strong understanding of hospice regulations, compliance, and Medicare conditions of participation + Proven ability to manage teams, budgets,… more