- Sedgwick (Orlando, FL)
- …Description** + Set up new Medicare Lien Resolution (MLR) referrals in the Medicare Compliance System + Electronically sort and index Medicare mail in ... the SIR and Medicare Compliance systems + Responds to questions from examiners about Medicare Compliance processes and products + Documents activity in… more
- Molina Healthcare (FL)
- **(Sales) Compliance Analyst** Molina Healthcare's Medicare Compliance team supports sales operations for the Molina Medicare product lines. It is a ... Operating Procedures and Training documents. . Lead regularly scheduled Sales & Compliance leadership meetings. . Interpret and analyze Medicare , Medicaid, and… more
- BayCare Health System (Clearwater, FL)
- …judgment at all times. **Minimum Qualifications:** **Experience:** + 5 years of Medicare compliance experience **Education:** + Required - Bachelors - Business; ... dignity, respect, responsibility and clinical excellence. **Summary:** + Assist the Chief Compliance Officer to continuously develop the Health Plans Compliance … more
- Humana (Tallahassee, FL)
- …requirements development. + Creating and executing comprehensive test plans + Ongoing Medicare Pricer maintenance, quality assurance, and compliance + Determine ... community and help us put health first** The Sr. Medicare (PPS) Provider Hospital Reimbursement Analyst will be an...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
- Sedgwick (Miami, 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
- Prime Therapeutics (Tallahassee, FL)
- …every decision we make. **Job Posting Title** VP Government Programs - Medicare & Managed Medicaid (REMOTE) **Job Description** The Vice President Government ... Programs - Medicare & Managed Medicaid is responsible for the development,...objectives are met and/or exceeded; instill a culture of compliance , accountability, and superior service within the Government Programs… more
- Humana (South Miami, 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
- Elevance Health (Tampa, 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
- Robert Half Accountemps (Boca Raton, FL)
- Description We are looking for a skilled Medicare Biller to join our team on a contract basis in Boca Raton, Florida. In this role, you will ensure accurate billing ... processes and compliance with regulations in the healthcare industry. This position...in E/M coding and auditing principles. * Familiarity with Medicare claims, payer denials, and CPT codes. * Strong… more
- CenterWell (Tallahassee, FL)
- …or similar methodologies. ** Compliance & Risk Management** * Ensure compliance with Medicare , Medicaid, and commercial payer authorization and revalidation ... patient access. The Director partners closely with clinical leadership, operations, finance, compliance , and IT, and manages both onshore and offshore teams. The… more