- Elevance Health (Tampa, FL)
- … Medicare and Medicaid Services to transform federal health programs. The ** Audit and Reimbursement Senior** will support our Medicare Administrative Contract ... + Requires a BA/BS and a minimum of 8 years of audit /reimbursement or related Medicare experience; or any combination of education and experience which would… more
- Elevance Health (Tampa, FL)
- …Requirements:** + Requires a BA/BS degree and a minimum of 5 years of audit /reimbursement or related Medicare experience; or any combination of education and ... ** Audit & Reimbursement III** **Location** : This role...Health's family of brands. We administer government contracts for Medicare and partner with the Centers for Medicare… more
- Walmart (Orlando, FL)
- …process Medicare orders to ensure compliance; and interpreting and documenting Medicare audit documents. + Ensures fulfillment of pharmacy prescriptions in a ... documentation; and maintaining a safe and clean work environment. + Complies with Medicare and Medicaid policies and procedures by implementing and adhering to rules… more
- WelbeHealth (Tallahassee, FL)
- …growth drivers + Assist with month-end close, quarterly financial reporting, financial audit , Medicare /Medicaid audits, and other PACE specific projects + Keep ... payment model, including ability to track and analyze revenue streams (eg Medicare , Medicaid, Part D) along with PACE rates and regulatory constructs **Job… more
- Humana (Tallahassee, FL)
- …other sources of expertise. The Behavioral Health Medical Directors will learn Medicare , Medicare Advantage and Medicaid requirements, and will understand how ... participate in meetings involving care management, provider relations, quality of care, audit , grievance and appeal and policy review. The Behavioral Health Medical… more
- Molina Healthcare (Jacksonville, FL)
- …from regulatory agency through analysis and response to findings. * Organize audit submissions, interact directly with auditors for all lines of business as ... of internal corrective action plans (CAPs) for both internal and external audit findings via coordination of responses to assure appropriateness as it relates… more
- Molina Healthcare (Tampa, FL)
- …durable fixes, and convert disciplined CTM management into Stars gains, audit readiness, and measurable member-experience improvements. You'll begin as a senior ... related field (advanced degree a plus). **Experience** * 7+ years managing Medicare CTM, appeals & grievances, or related compliance functions-hands-on with CMS CTM… more
- Molina Healthcare (St. Petersburg, FL)
- …Data Validation) team, assisting in the execution of CMS and internal audit activities. This position contributes to the development of chart retrieval chase ... gain exposure to end-to-end RADV workflows and contribute to meaningful audit readiness efforts. **Knowledge/Skills/Abilities** + Assist with the identification and… more
- BayCare Health System (Clearwater, FL)
- … Fiscal Intermediaries) Equal Opportunity Employer Veterans/Disabled **Position** Audit and Compliance Supervisor - Patient Financial Services **Location** ... 8:00AM -4:00PM + **Days:** Monday through Friday, occasional weekends This Audit and Compliance Supervisor opportunity is a full-time position. This position… more
- Centene Corporation (Tallahassee, FL)
- …of risk adjustment regulatory landscape preferred + Risk Adjustment regulatory audit experience preferred + Medicare experience preferred Pay Range: ... Adjustment processes. Ensures visibility by way of reporting out audit deliverables and risk related to each audit . + Serves as the point of contact for external… more