- MyFlorida (Daytona Beach, FL)
- …others as necessary. Reviews open encumbrance reports for accuracy and budgetary compliance and assists appropriate staff to resolve issues. Assists in budget ... insurance and processes all claims accordingly; researching claims for Medicaid, Medicare and other third party insurances; contacting insurance carriers when… more
- Humana (Tallahassee, FL)
- …develops, implements, and manages clinical program strategies to improve Medicare members' medication adherence and appropriate medication use with specific ... + 2 or more years of project leadership experience + Prior Medicare /Medicaid experience + Strategic thinking and planning capabilities; organized and detail-oriented… more
- Humana (Tallahassee, FL)
- …develops, implements, and manages clinical program strategies to improve Medicare members' medication adherence and appropriate medication use. The Clinical ... from complex data Preferred Qualifications + Previous experience in Medicare Stars + Managed care and/or community pharmacy experience...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
- Robert Half Accountemps (Land O' Lakes, FL)
- …managing accounts receivable for various secondary insurance balances, including Commercial, Medicare Advantage, Blue Cross, Workers Comp, Auto, and other non- ... Medicare payers. The position requires expertise in claim denial...address billing, collections, and account follow-up challenges. * Ensure compliance with healthcare industry regulations and organizational policies. *… more
- Highmark Health (Tallahassee, FL)
- …clients and members, including executing events and campaigns across the commercial, Medicare and community segments. The incumbent works with highly complex members ... events and campaigns across all segments of business such as commercial, Medicare and community, independently and/or in partnership with executives across the… more
- Highmark Health (Tallahassee, FL)
- …to the team. They support the full-cycle ownership of commercial and Medicare Advantage medical policies, both developed internally and by vendors. This includes ... required. **ESSENTIAL RESPONSIBILITIES** + Full-cycle ownership of commercial and Medicare Advantage medical policy creation process including writing clinical… more
- Humana (Miramar, FL)
- …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 ... Word, Outlook, and Excel is preferred. + Knowledge of Medicare /Medicaid & commercial insurance is required. + Experienced with...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
- Humana (Tallahassee, FL)
- …CFO team, which drives aggregate financial results and insights across primarily Individual Medicare Advantage (MA). This team serves as a central hub for financial ... focused on continuously improving consumer experiences **Preferred Qualifications** + Medicare Advantage pricing and forecasting experience + Experience working with… more
- Humana (Tallahassee, FL)
- …CFO team, which drives aggregate financial results and insights across primarily Individual Medicare Advantage (MA). This team serves as a central hub for financial ... filing, reporting & analysis, reserving or trending) **Preferred Qualifications** + Medicare Advantage pricing and forecasting experience + Experience working with… more
- NHS Management, LLC (Daytona Beach, FL)
- …resolution and development of business office goals and objectives. + Strives for compliance with internal controls and state and federal regulations. + Ability to ... other business office related tasks, including but not limited to: + Medicaid, Medicare and/or secondary billing + Assist with evaluation and selection of all… more