- Humana (Tallahassee, FL)
- …teaching conferences, and other reference sources. Medical Directors will learn Medicare , Medicaid, and Medicare Advantage requirements and will understand ... preferably includes experience in an inpatient environment and/or related to care of a Medicare type population (disabled or >65 years of age). + Current and ongoing… more
- Polaris Pharmacy Services, LLC (Fort Lauderdale, FL)
- …portfolio of rejected pharmacy claims to ensure maximum payer reimbursement and timely billing to eliminate financial risks to Polaris and their customers. The Prior ... of rejected pharmacy claims to ensure maximum payer reimbursement and timely billing to eliminate financial risks to Polaris and their customers + Research,… more
- Cardinal Health (Tallahassee, FL)
- …simplify and optimize the practice's revenue cycle, from prior authorization through billing and collections. Job Purpose: The Patient AR Specialist is responsible ... of accounts and supporting overall revenue cycle process. This includes, billing follow up, collections, payment posting, denial resolution, and responding to… more
- MyFlorida (Moore Haven, FL)
- …bill, collection of fees, balancing through the Health Management System (HMS) billing function, which identifies cash collections, billings to Medicaid, Medicare ... staff in serving clients from an interdisciplinary approach. Dental Billing :Retrieve signed authorization from case Manager. Scheduling new patient appointments… more
- Robert Half Accountemps (Land O' Lakes, FL)
- …related to secondary insurance balances across various payer types, including Commercial, Medicare Advantage, Workers Comp, and Auto. You will contribute to claim ... secondary insurance accounts receivable across multiple financial classes, including Commercial, Medicare Advantage, Blue Cross, and Workers Comp. * Investigate and… more
- Cardinal Health (Tallahassee, FL)
- **_What Customer Service Operations contributes to Cardinal Health_** Contracts and Billing is responsible for finance related activities such as customer and vendor ... contract administration customer and vendor pricing, rebates, billing (including drop-ships), processing chargebacks and vendor invoices and developing and… more
- Humana (Miramar, FL)
- …provider interactions and communications. Work with Pre-Authorization, Utilization Management, Billing , Pharmacy, Home Care and DME regarding referred services. ... of applicable CPT, HCPC, ICD-10 codes, and all insurance contracts. Understand Medicare /Medicaid criteria and Health Plan policies to ensure the referral meets all… more
- Humana (Tallahassee, FL)
- …Principal coordinates, implements, and manages oversight of the company's Medicare /Medicaid Stars Program for aligned areas. The Stars Improvement Principal ... Operations encompasses critical functions including care coordination, quality measurement, billing , claims processing, and customer service, each essential to… more
- Humana (Miramar, FL)
- …Auditor ensures clinical documentation meets CMS regulations, OASIS accuracy, and Medicare Conditions of Participation. This role audits Start of Care, ... for compliance, accuracy, and completeness, helping reduce audit risk and billing delays. The auditor monitors QA metrics, identifies trends, and collaborates… more
- Cardinal Health (Tallahassee, FL)
- …and manages compliance audits to determine organizational integrity of billing for professional (physician) services and/or hospital (technical) services. This ... documentation and coding related to physician or hospital (inpatient and outpatient) billing and/or medical necessity reviews. + Prepares written reports of audit… more