• General & Product Liability Complex Claim Examiner…

    Sedgwick (Miami, FL)
    …limited to: subrogation, Second Injury Fund excess recoveries and Social Security and Medicare offsets. + Reports claims to the excess carrier; responds to requests ... principles including medical management practices and Social Security and Medicare application procedures as applicable to line-of-business. + Excellent oral… more
    Sedgwick (08/08/25)
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  • RN Care Manager Remote with field travel in WA…

    Molina Healthcare (Miami, FL)
    …and the site of service. This position will be supporting our Washington State Medicare plan. We are seeking a candidate with previous Case Management experience and ... proficient knowledge of MS Suite, organized and analytical thinking. Experience with Medicare /Medicaid, MS 365 and familiarity with claims is highly preferred. The… more
    Molina Healthcare (08/08/25)
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  • Specialist, Government Contracts - Remote in EST

    Molina Healthcare (FL)
    …administration of contracts with State and/or Federal governments for Medicaid, Medicare , Marketplace, and other government-sponsored programs to provide health care ... Experience** * 2+ years compliance related experience. * 1+ years in Medicare . **Preferred License, Certification, Association** N/A To all current Molina employees:… more
    Molina Healthcare (08/08/25)
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  • Patient Access Representative 1 (On-Site) Full…

    University of Miami (Miami, 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
    University of Miami (08/08/25)
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  • Senior Inpatient Coding Specialist

    AdventHealth (Orlando, FL)
    …record, applying appropriate ICD-10-CM/PCS coding conventions and MS-DRG Medicare Prospective Payment System requirements. Actively participates in outstanding ... ICD-10-CM rules and conventions, coding policy and procedures, requirements of Medicare / payer specifications, and official coding guidelines as outlined by… more
    AdventHealth (08/07/25)
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  • VP Quality AdventHealth Central Florida Division…

    AdventHealth (Altamonte Springs, FL)
    …from the work of this committee are required to receive Medicare reimbursement for the organization. Responsible for developing Institute accreditation vision, ... forecast upcoming regulatory and public-reporting trends such as Centers for Medicare and Medicaid Services (CMS) Value-Based Purchasing, Agency for Healthcare… more
    AdventHealth (08/07/25)
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  • Home Health Licensed Practical Nurse LPN Full Time

    Aveanna Healthcare (Fort Myers, 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 (08/04/25)
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  • Home Health Registered Nurse RN Full Time

    Aveanna Healthcare (Dade City, 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
    Aveanna Healthcare (08/03/25)
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  • National Director Market Access and Payer Strategy

    BD (Becton, Dickinson and Company) (Stuart, FL)
    …to ensure optimal coverage and maximize reimbursement from Commercial, Medicaid and Medicare plans. The individual will also have direct supervision of the contract ... and execution of the commercial reimbursement strategy including Medicaid and Managed Medicare plans. ​ + Responsible and accountable for optimizing the Company's… more
    BD (Becton, Dickinson and Company) (08/02/25)
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  • Utilization Management Nurse

    CenterWell (Tallahassee, FL)
    …Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/ Medicare /Medicaid Experience a plus + Current nursing ... experience in Hospital, SNF, LTAC, DME or Home Health. + Bilingual We offer tangible and intangible benefits such as medical, dental and vision benefits, 401k with company matching, tuition reimbursement, 3 weeks paid vacation time, paid holidays, work-life… more
    CenterWell (08/02/25)
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