• Manager Cellular Therapy Lab

    HCA Healthcare (Gainesville, FL)
    …Improvements Act (CLIA) as well as compliance with standards of the Centers for Medicare & Medicaid Services ( CMS ). The Manager supervises all employees in the ... role: + Act as the Cell Processing Laboratory Quality Management Supervisor. + Develop new, or revise policies and...staff and is the liaison between staff and upper management . + Assume responsibility and accountability for efficient and… more
    HCA Healthcare (06/21/25)
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  • Profee Complex Coder Cardiology

    Banner Health (FL)
    …and regulations according to regulatory agencies for state Medicaid plans, Center for Medicare Services ( CMS ), Office of the Inspector General (OIG) and the ... (RHIT), in an active status with the American Health Information Management Association (AHIMA) or American Academy of Professional Coders (AAPC). Certification… more
    Banner Health (08/02/25)
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  • Clinical Liaison LPN

    HCA Healthcare (Fort Myers, FL)
    …are met. 2. Creates and maintains a positive relationship with the hospital Case Management team. 3. After a referral from the hospital CM, meets with patients to ... acceptance including support of electronic platform referrals. Ensures the patient meets CMS criteria for home health services. 5. Ensures required documentation is… more
    HCA Healthcare (08/01/25)
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  • Compliance Analyst (MI Health Plan) - REMOTE…

    Molina Healthcare (FL)
    …inquiries. + Performs Plan Required Reporting. + Interpret and analyzes Medicare , Medicaid and MMP Required Reporting Technical Specifications. + Create and ... quarterly Key Performance Indicator (KPI) reports. + Support the management of the regulatory memo distribution process Ability to...notices of proposed rulemaking. + Manages user access to CMS . + Analyze data use critical thinking + Ability… more
    Molina Healthcare (07/19/25)
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  • Facility Coding Inpatient Complex Coder

    Banner Health (FL)
    …and regulations according to regulatory agencies for state Medicaid plans, Center for Medicare Services ( CMS ), Office of the Inspector General (OIG) and the ... certification in an active status with the American Health Information Management Association (AHIMA) or American Academy of Professional Coders (AAPC). Requires… more
    Banner Health (07/10/25)
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  • Epic Sr. Analyst - Quality and Population Health

    University of Miami (Miami, FL)
    …you will: + Build and maintain Clinician's workflow and HEDIS quality measure for Medicare Advantage programs + Build and maintain CMS Quality Payment Program ... tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . The University of Miami Health System , "UHealth", IT Department has an exciting opportunity for… more
    University of Miami (05/31/25)
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  • Claims Adjudication Specialist

    Cognizant (Tallahassee, FL)
    …ICD-10 * Experience making payments with UB/institutional ( CMS -1450) and/or professional ( CMS 1500) claims * Knowledge of Medicare / Medicaid payment and ... Responsible for reviewing the data in the claim processing system and comparing with corresponding UB or HCFA paper...Assigning special projects or other duties as determined by management . **What you need to have to be considered:**… more
    Cognizant (08/20/25)
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  • ASC Surgical Coder

    TEKsystems (Orlando, FL)
    …general surgery. * Strong understanding of CPT guidelines for outpatient surgery and Medicare 's ASC payment system . Skills Surgical Coder, Surgical Coding, ASC, ... * Assign accurate CPT, ICD-10-CM, and HCPCS Level II codes in accordance with CMS , AMA, ASC, and payer-specific guidelines. * Apply correct modifiers to reflect the… more
    TEKsystems (08/13/25)
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  • Medical Claims Adjudication - remote

    Cognizant (Tallahassee, FL)
    …+ Experience making payments with UB/institutional ( CMS -1450) and/or professional ( CMS 1500) claims. + Knowledge of Medicare /Medicaid payment and coverage ... and other teams. **Primary Responsibilities** : + Review claim system data and verify against UB or HCFA paper...and external SLAs. + Other duties as assigned by management . **Qualifications:** + A minimum of 2 years' claims… more
    Cognizant (08/01/25)
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  • Auditor, Risk Adjustment (Remote)

    Molina Healthcare (Miami, FL)
    …and procedures to ensure accuracy, completeness, and compliance with Centers for Medicare and Medicaid Services ( CMS ) regulations and guidelines of risk ... CPC credential **Preferred Education** Bachelor's Degree in Business Administration, Health Care Management o To all current Molina employees: If you are interested… more
    Molina Healthcare (07/25/25)
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