- Merck (Tallahassee, FL)
- …or reimbursement support * Strong knowledge of health insurance structures ( Medicare Part B, Medicaid, commercial) and related access processes, including benefit ... verification, prior authorization, and appeal processes * Expertise in pharmaceutical compliance and HIPAA regulations regarding patient confidentiality * Excellent interpersonal and communication skills; demonstrated ability to engage and influence diverse… more
- Molina Healthcare (Orlando, FL)
- …National Committee of Quality Assurance (NCQA) guidelines, and Centers for Medicare and Medicaid Services (CMS) standards. * Provides coordination and processing ... of pharmacy prior authorization requests and/or appeals. * Explains point-of-sale claims adjudication, state, NCQA and CMS policies/guidelines, and any other necessary information to providers, members and pharmacies. * Assists with clerical tasks and other… more
- Molina Healthcare (Miami, FL)
- …or other health care or management certification. * Leadership experience. * Medicaid/ Medicare population experience. To all current Molina employees: If you are ... interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $77,969 - $171,058 /… more
- CVS Health (Tallahassee, FL)
- …+ 3+ years of experience in healthcare. + Working knowledge of Medicare , Medicaid and Third-Party Insurance payers and reimbursement guidelines. + Strong competency ... with Microsoft Office software applications (Outlook, Word, Excel). **Preferred Qualifications** + Excellent attention to detail, as well as the ability to handle stress and meet deadlines. + Strong organizational skills, as well as the ability to manage… more
- HCA Healthcare (Largo, FL)
- …to providing patients with quality care during their recovery at home. We are Medicare certified. Our patients are under the supervision of a physician and our team ... of professionals develop an individualized plan of care. Our professionals include registered nurses, licensed practical nurses, therapists, and social workers. We provide the care you need in the comfort of your own home to restore your independence.… more
- ChenMed (Orlando, FL)
- …mission-driven, primary care organization, is currently one of the most successful full-risk Medicare Advantage providers in the nation and has a vision to be ... America's leading primary care provider, transforming care of the neediest population. Our mission is to honor seniors with affordable VIP care that delivers better health. In order to achieve our vision and deliver our mission, we need the best primary care… more
- Humana (Tampa, FL)
- …efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities at large. ... **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic… more
- NHS Management, LLC (Tallahassee, FL)
- …understanding of GAAP and financial reporting principles. + Staff management experience + Medicare and Medicaid billing experience in the long term care industry + ... Collections experience + Proficiency in Microsoft Excel and other financial software. + Excellent analytical, problem-solving, and communication skills. + Ability to work independently and as part of a team. + Strong attention to detail and organizational… more
- ChenMed (St. Petersburg, FL)
- …strongly preferred + Healthcare experience in a clinical setting, preferably within the Medicare HMO population is a plus + A valid, active driver's license in ... State of employment is required; position may require travel within the market + Medical Assistant certification preferred + CPR for Healthcare Providers is preferred **PAY RANGE:** $16.5 - $23.56 Hourly **EMPLOYEE BENEFITS**… more
- Intermountain Health (Tallahassee, FL)
- …Billing, Follow-Up, Collections) required + Knowledge of Medicaid and Medicare billing regulations required **Physical Requirements** + Operate computers and ... other office equipment requiring the ability to move fingers and hands. + Remain sitting or standing for long periods of time to perform work on a computer, telephone, or other equipment. + May require lifting and transporting objects and office supplies,… more