- HCA Healthcare (Hudson, FL)
- …practices in adherence with corporate accounting policy (APG) and internal audit guidelines; interprets data, and prepares financial analyses of operations for ... the preparation of the annual financial reports including but not limited to: Medicare Cost Report, work paper package and the AHCA prior year report package.… more
- HCA Healthcare (Sarasota, FL)
- …practices in adherence with corporate accounting policy (APG) and internal audit guidelines; interprets data, and prepares financial analyses of operations for ... the preparation of the annual financial reports including but not limited to: Medicare Cost Report, work paper package and the AHCA prior year report package.… more
- Humana (Tallahassee, FL)
- …ensuring appropriateness of billing practices. Prepares complex investigative and audit reports. Understands department, segment, and organizational strategy and ... Coding or Healthcare (Medical Chart Review/Insurance Billing) or Internal/External Audit or Regulatory/Compliance OR Claims Investigations or Criminal Investigation/White… more
- HCA Healthcare (Brooksville, FL)
- …practices in adherence with corporate accounting policy (APG) and internal audit guidelines; interprets data, and prepares financial analyses of operations for ... the preparation of the annual financial reports including but not limited to: Medicare Cost Report, work paper package and the AHCA prior year report package.… more
- BrightSpring Health Services (Sarasota, FL)
- …ensure that all federal and state law requirements and conditions of participation for Medicare and Medicaid are met. + Gather data for assigned area(s) and prepare ... concerns. + Respond in writing or verbally to client or community concerns, audit requests, and/or contract complaints regarding quality of services and programs and… more
- Polaris Pharmacy Services, LLC (Fort Lauderdale, FL)
- …payor verification * Verify insurance and Medicaid coverage * Handle Dual Coverage, Medicare Part D, and Commercial Plans related to Long-Term Care * Address ... professionally * Enter fees and charges in Framework LTC * Prepare and audit daily, weekly, and monthly billing reports * Generate statements and end-of-month… more
- Molina Healthcare (Tampa, FL)
- …MCG, InterQual or other medically appropriate clinical guidelines, Medicaid, Medicare , CHIP and Marketplace, applicable State regulatory requirements, including the ... + Active and unrestricted Certified Clinical Coder + Certified Medical Audit Specialist + Certified Case Manager + Certified Professional Healthcare Management… more
- AdventHealth (Tampa, FL)
- …coverage decisions in conjunction with medical charts to ensure compliance with Medicare , Medicaid and other third-party payers as well as to ensure appropriate ... frame provided. Educate staff as appropriate to address concerns identified in audit of patient charts/charges Educate all Regional auditors in area of Supervision… more
- Centene Corporation (Tallahassee, FL)
- …guidelines + Track and trend overrides to ensure criteria have been met, audit for prior authorizations, analyze cost and determine utilization patterns + Resolve ... 3+ years of pharmacy experience, preferably in a managed care environment. Medicare and/or Medicaid experience preferred. Prior experience using analysis tools or… more
- Centene Corporation (Tallahassee, FL)
- …guidelines + Track and trend overrides to ensure criteria have been met, audit for prior authorizations, analyze cost and determine utilization patterns + Resolve ... 3+ years of pharmacy experience, preferably in a managed care environment. Medicare and/or Medicaid experience preferred. Prior experience using analysis tools or… more