- AdventHealth (Altamonte Springs, FL)
- …activities. These activities include preparation and filing the annual Medicare , Medicaid, and Champus/Tricare cost reports; preparation of reopening and ... of proposed operational decisions; and serves as subject matter resource for Medicare and Medicaid reimbursement matters. The Director is responsible for creating a… more
- Humana (Tallahassee, FL)
- …Excel **Preferred Qualifications** + BSN or Bachelor's degree in a related field + Medicare /Medicaid health plan experience + MCG experience + Bilingual is a plus + ... Certified Case Manager (CCM) + Ability to work independently...recognized leader in healthcare delivery that has been offering Medicare Advantage health plans in Florida over 23 years.… more
- CVS Health (Tallahassee, FL)
- …records coded by internal teams prior to the submission to the Centers of Medicare and Medicaid Services (CMS) for the purpose of risk adjustment processes are ... record documentation review, diagnosis coding, and/or auditing. + Experience with Medicare and/or Commercial and/or Medicaid Risk Adjustment process and Hierarchical… more
- Medical Mutual of Ohio (Fort Myers, FL)
- …and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans. **Provides telephonic/virtual, ... clinical experience. **Professional Certification(s):** + Licensed Mental Health Clinician, Certified HR Professional, or Certified EAP Counselor preferred… more
- Banner Health (FL)
- …Auditing experience;** + **Bachelors degree or equivalent;** + **Must be currently certified through AAPC or Ahima, as defined in minimum qualifications below. ... knowledge of clinical documentation and its impact on reimbursement under Medicare Severity Adjusted System (MS-DRG),All Payer Group (APR-DRG) and Ambulatory Payment… more
- CenterWell (Deerfield Beach, FL)
- …for TB **Preferred Qualifications:** . Board Certification or Eligible to become certified (ABMS or AOA) in Family Medicine, Internal Medicine or Geriatric Medicine ... preferred . Active and unrestricted DEA license . Medicare Provider Number . Medicaid Provider Number . Minimum of two to five years directly applicable experience… more
- CVS Health (Tallahassee, FL)
- …applicable) to ensure the ICD codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) for the purpose of risk adjustment processes are ... medical record documentation review, diagnosis coding, and/or auditing. + CPC ( Certified Professional Coder) or CCS-P ( Certified Coding Specialist-Physician)… more
- Molina Healthcare (Tampa, FL)
- …with Medicare , Medicaid, and Marketplace lines of business. + Certified Business Analysis Professional (CBAP), or Certified Coding Specialist (CCS) ... Ownership** + Assists and executes tasks and projects to ensure Centers for Medicare & Medicaid Services (CMS) and State regulatory requirements are met for Pre-pay… more
- CenterWell (Delray Beach, FL)
- …program from an accredited university + Board Certification or Eligible to become certified (ABMS or AOA) in Family Medicine, Internal Medicine or Geriatric Medicine ... **Preferred Qualifications:** . Board certification or eligible to become certified (ABMS or AOA) in Family Medicine, Internal Medicine...Medicine preferred . Active and unrestricted DEA license . Medicare Provider Number . Minimum of two to five… more
- Molina Healthcare (St. Petersburg, FL)
- …with Medicare , Medicaid, and Marketplace lines of business. + Certified Business Analysis Professional (CBAP), or Certified Coding Specialist (CCS) ... and executes tasks and projects to ensure Centers for Medicare & Medicaid Services (CMS) and State regulatory requirements...At least 3 years of Experience with Medicaid and/or Medicare . + Proven experience owning operational projects from concept… more