- 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
- Ochsner Health (Pensacola, FL)
- …OR additional combination of formal education, training, and applicable experience with Medicare Advantage. **Work Experience** Required - 3 years of experience in ... Microsoft Excel, Word, PowerPoint, Outlook, and SalesForce. + Value-based care, medicare advantage, data analysis, project management. + Ability to efficiently… more
- Humana (Tallahassee, FL)
- …have comprehensive knowledge of processes, policies and procedures as well as compliance guidelines. Will support achieving operational and compliance key ... or adjacent sectors **Preferred Qualifications** + Comprehensive knowledge of Medicare , Medicaid, and DSNP encounter processes and policies. + Familiarity… more
- CVS Health (Tallahassee, FL)
- …CDQA) to ensure the ICD-10 codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) for the purpose of risk adjustment processes are ... to appropriate departments and management. + Conducts process audits to ensure compliance with internal policies and procedures and existing CMS regulations. +… more
- Humana (Tallahassee, FL)
- …time with demonstrated advanced communication and interpersonal skills. This is a very compliance driven and highly visible program at Humana. The nature of the work ... concurrently navigating multiple computer applications. Due to the auto dialer process and compliance needs of the business there is limited day to day flexibility… more
- University of Miami (Doral, FL)
- …facilitating the understanding of and obtaining signature on legal, ethical, and compliance related documents that must be presented and thoroughly explained to the ... HIPAA Notice of Privacy, No Surprise Billing, Good Faith Estimate, Off Campus Medicare Co-insurance and Advance Beneficiary Notices, and Medicare Secondary Payer… more
- Molina Healthcare (Jacksonville, FL)
- …oversight of processes that track, evaluate, and submit encounter deletions for Medicare Advantage, ACA, and Medicaid lines of business. This role has ... decision-making accountability for ensuring compliance with complex regulatory requirements, protecting the integrity of enterprise revenue, and enabling the… more
- AdventHealth (Altamonte Springs, FL)
- …to achieve clinical excellence and organizational accountabilities. ** Compliance /Regulatory Responsibility** : Executive oversight of submission, monitoring, ... all aspects of quality across CFD-S for responsible for ensuring organizational compliance on regulatory related quality mandates for CMS, AHCA, and other regulatory… more
- CenterWell (Edgewater, FL)
- …local primary care "on-call" program of Conviva as needed. . Assures personal compliance with licensing, certification, and accrediting bodies. . Spend 100% of your ... . New graduates will be considered . Experience managing Medicare Advantage panel of patients with understanding of Best...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
- Molina Healthcare (Miami, FL)
- …Molina Healthcare's overall mission, core values, and strategic plan and in compliance with all relevant federal, state and local regulations. Plans, organizes, ... and Joint Operating Committees. * Manages and reports network adequacy for Medicare , Marketplace, and Medicaid services. * In conjunction with direct management and… more