- Convey Health Solutions (Fort Lauderdale, FL)
- …departments. This role plays a key part in maintaining organizational integrity and compliance with Medicare and other healthcare program requirements. The ... continuous improvement initiatives. Key Duties and Responsibilities: + Assist the Compliance Manager in accessing and interpreting Medicare program guidelines.… more
- Elevance Health (FL)
- …of managerial experience is strongly preferred + Experience with IRE/Maximus and Medicare compliance , programs, guidelines, and processes are strongly preferred. ... and operational and plan risk, ensures quality, and regulatory compliance . This role specifically oversees the IRE Team. **How...regulated audits. + Oversight of the IRE portions of Medicare audits and universe production. + Serves as a… more
- AdventHealth (Tampa, FL)
- …and support as needed. **The value you'll bring to the team:** Performs Medicare compliance reviews and issues Advance Beneficiary Notices of Noncoverage as ... needed. Creates accurate estimates for patient financial responsibility and collects payments or establishes payment plans. Coordinates with utilization management staff for pre-authorization issues and ensures patients have necessary logistical information.… more
- AdventHealth (Ocala, FL)
- …and support as needed. **The value you'll bring to the team:** Performs Medicare compliance reviews and issues Advance Beneficiary Notices of Noncoverage as ... needed. Creates accurate estimates for patient financial responsibility and collects payments or establishes payment plans. Coordinates with utilization management staff for pre-authorization issues and ensures patients have necessary logistical information.… more
- Sedgwick (Orlando, FL)
- …and laws + Knowledge of medical terminology for claim evaluation and Medicare compliance + Knowledge of appropriate application for deductibles, sub-limits, ... SIR's, carrier and large deductible programs. + Strong oral and written communication, including presentation skills + PC literate, including Microsoft Office products + Strong organizational skills + Strong interpersonal skills + Good negotiation skills +… more
- Humana (Miami Lakes, FL)
- …of everything it does. The MarketPoint Career Channel Team is looking for skilled Medicare Field Sales Agents. This is a field-based role, and candidates must live ... community. As part of a collaborative team of 8-12 Medicare Sales Agents, you'll work under the guidance of...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
- Prime Therapeutics (Tallahassee, FL)
- …analytical skills **Preferred Qualifications** + PBM/health care experience related to Medicare , Medicaid, Commercial, HIM + Certified Compliance and Ethics ... passion and drives every decision we make. **Job Posting Title** Senior Compliance Analyst (Risk Assessment and Oversight) - Remote **Job Description** The Senior… more
- CVS Health (Tallahassee, FL)
- …talent! We have an exciting opportunity available for highly motivated individuals as Medicare Sales Specialist. The position will be a part of a specialized team ... who will focus on educating existing Medicare members on available plan offerings to help meet...selling applicable products to existing members. + Maintaining high compliance commitment and standards with a robust knowledge with… more
- Elevance Health (Miami, FL)
- **Medical Director- Florida Medicare Plans** Location: This role enables associates to work virtually full-time, with the exception of required in-person training ... Tampa locations.** The **Medical Director** will support the following Florida Medicare plans: Simply Healthcare Plans, Healthsun Plans, Freedom Health, and Optimum… more
- BAYADA Home Health Care (Jacksonville, FL)
- …supervision and support to field RNs, LPNs, and clinical staff + Ensure compliance with Medicare Conditions of Participation (CoPs), state regulations, and ... Nurse (RN) to fill the position of **Nurse Manager** for our Jacksonville, FL Medicare Certified, Home Health office. Do you want to be part of providing care… more