- Humana (Tallahassee, FL)
- …English/Spanish + Bilingual English/Creole + Experience working with Medicare and Medicaid **Additional Information** **Work-At-Home Requirements:** To ensure ... paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 12-21-2025 **About us**… more
- AdventHealth (Maitland, FL)
- …minimal supervision, provides necessary research, review and interpretation of Insurance Provider Manuals, payment methodologies, and reimbursement rates. Maintains ... for Florida and multi-state hospital providers, with a concentration on Medicare , state specific Medicaid, non-contracted payers, and Tricare. Consults with key… more
- Humana (Tallahassee, FL)
- …+ Previous experience with pharmacy benefits management + Previous Commercial, Medicare and/or Medicaid experience + 3 or more years clinical experience ... off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. **About us** Humana Inc. (NYSE: HUM) is… more
- AdventHealth (Tampa, FL)
- …+ Coordinating information flow among medical, ancillary, nursing, financial and insurance personnel + Facilitate and direct BLS/ACLS measures as necessary + ... coding and completing diagnosis of patient's condition to facilitate appropriate insurance reimbursement. . Post-operative patient ICU and floor management . Call… more
- Humana (Tallahassee, FL)
- …states: California, Hawaii, Nevada, Oregon + Health Plan experience + Previous Medicare /Medicaid Experience a plus + Call center or triage experience + Bilingual ... paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. **About us** About OneHome: OneHome coordinates… more
- Aveanna Healthcare (St. Petersburg, FL)
- …Offerings: + 401(k) with company match + Health, dental, vision, life, and pet insurance + Mileage reimbursement and cell phone allowance + Generous PTO, sick time, ... + Valid CPR and valid Drivers License Preferred: + Medicare Skilled Nursing experience + Basic understanding of Oasis...in a health care setting As an employer accepting Medicare and Medicaid funds, employees must comply with all… more
- Cognizant (Tallahassee, FL)
- …based on the review of clinical documentation in accordance with Medicare , Medicaid, and third-party guidelines. . Effectively document and log claims/appeals ... Reviews can be based on InterQual, Milliman Clinical Guidelines (MCG), Medicare guidelines, and health insurer specific guidelines. . Review retro-authorizations in… more
- CenterWell (Tallahassee, FL)
- …and monitoring the Tele Sales Agents who are responsible for converting Medicare eligible callers to patients. The Care Delivery Call Quality Professional is ... quality auditing experience + Understanding of value-based primary care and/or Medicare Advantage + Familiarity with healthcare systems and patient satisfaction… more
- Aveanna Healthcare (West Palm Beach, FL)
- …Offerings: + 401(k) with company match + Health, dental, vision, life, and pet insurance + Mileage reimbursement and cell phone allowance + Generous PTO, sick time, ... application * Valid CPR and Drivers License Preferred: * Medicare Skilled Nursing experience * Basic understanding of Oasis...in a health care setting As an employer accepting Medicare and Medicaid funds, employees must comply with all… more
- Prime Therapeutics (Tallahassee, FL)
- …all provider and member materials and communications, and product ownership for Medicare and Medicaid formularies + Provide consultation and recommendations to the ... to the plan + Provide clinical guidance and support for client's Health Insurance Marketplace business + Manage incoming requests for information from the plan… more