- HCA Healthcare (Miami, FL)
- …leadership + Work with team members in billing, revenue integrity and/or the Medicare Service Center to resolve alerts/edits + Assign interim DRGs for in-house ... patients at month end + Complete MOCK abstracts as necessary (eg, combining the codes for outpatient and inpatient claims subject to the payment window) + Assist the Coding Leads and/or Coding Managers in resolving unbilled reason codes (URC)/Hold Reasons +… more
- HCA Healthcare (Atlantis, FL)
- …+ You will maintain a thorough working knowledge of the rules of Medicare , Medicaid, and private payer regulations and processes. You will possess a thorough ... understanding of managed-care concepts and length-of-stay management relating to patient and organizational fiscal responsibility. + You will perform thorough assessments and develop appropriate discharge plans for high-risk patients with discharge planning or… more
- Humana (Stuart, 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
- University of Miami (Fort Lauderdale, FL)
- …Advance Directives, HIPAA, No Surprise Billing, Good Faith Estimate, Off Campus Medicare Co-insurance, ABNs, and MSPQ, prior to services being rendered. + Provides ... financial counseling services at check-in, creates estimates, explains benefits, and notifies patients of self-pay liabilities including previous balances, and collects funds. + Collaborates with providers and clinical schedulers in coordinating and scheduling… more
- ChenMed (Jacksonville, FL)
- …are true hands-on caregivers transforming the health and lives of seniors on Medicare Advantage. Through our Value Based Care approach, you and your patients thrive ... in our high-touch, relationship-centered model - something the traditional, FFS healthcare model cannot provide. As a ChenMed physician, you have all the resources and team support you need to succeed. **As part of the ChenMed team:** **Our Physicians enjoy**… more
- HCA Healthcare (Margate, FL)
- …+ You will maintain a thorough working knowledge of the rules of Medicare , Medicaid, and private payer regulations and processes. You will possess a thorough ... understanding of managed-care concepts and length-of-stay management relating to patient and organizational fiscal responsibility. + You will perform thorough assessments and develop appropriate discharge plans for high-risk patients with discharge planning or… more
- Humana (Tallahassee, 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
- HCA Healthcare (Fort Walton Beach, FL)
- …The MSW maintains a thorough working knowledge of the rules of Medicare , Medicaid, and private payer regulations and processes, and possesses a thorough ... understanding of managed-care concepts and length-of-stay management relating to patient and organizational fiscal responsibility. The scope of this role includes intensive care units, Trauma, Oncolgy, NICU, Transplant, ED, and responds to physician,… more
- CenterWell (Tallahassee, FL)
- …+ Previous experience with pharmacy benefits management + Previous Commercial, Medicare and/or Medicaid experience + 3 or more years clinical experience ... in managed care + Ability to manage end-to-end-processes + Understand Humana's business processes, systems, tools, regulations and structure and how they interrelate to provide products and services that create value for Humana members + Previous management… more
- AdventHealth (Davenport, FL)
- …including but not limited to: Coordination of Care, Centers for Medicare & Medicaid Services (CMS) Conditions of Participation, Discharge Planning, Social ... Services, Readmission Prevention, Length of Stay, Excess days, Avoidable Days, Value Based Care partnerships, Care Manager's roles in Multidisciplinary Rounds, Care Transitions, team member engagement, team member evaluations and customer experience. The Care… more