- Healthfirst (FL)
- …visualization tools like Tableau and Knowledge of NY lines of business such as Medicare NY, Medicaid, Child Health Plus, QHP, EP, HARP + Bachelor's degree in ... Accounting, Finance, or Business Administration from an accredited institution preferred. + Certification in claims processing or related area (eg, CPC, AIC) WE ARE AN EQUAL OPPORTUNITY EMPLOYER. Applicants and employees are considered for positions and are… more
- Humana (Tallahassee, FL)
- …and other vendors. + Document all calls and requests. + Search for Medicare and Medicaid Guidelines. + Process all incoming fax/emails request for services the ... in special projects as assigned by your Supervisor or Manager . **Use your skills to make an impact** **Required...recognized leader in healthcare delivery that has been offering Medicare Advantage health plans in Florida over 23 years.… more
- BAYADA Home Health Care (Orlando, FL)
- …Health Care has an immediate opening for a **Full Time,** OASIS and Coding Review Manager with OASIS and Coding certification to work remotely. RN, PT, OT, and SLP's ... the OASIS and ICD 10 coding while using the Medicare PDGM billing model and CMS guidelines. + Review...Perform related duties, or as required or requested by Manager /Director. **Qualifications:** + Competency in PC skills required to… more
- CenterWell (Palm Coast, FL)
- …email, etc.). **Preferred:** + Experience in value-based care, primary care or Medicare Advantage settings. + Active DEA license and Medicare /Medicaid provider ... numbers or ability to obtain DEA license and/or Medicaid and Medicare numbers + Familiarity with HEDIS quality indicators and Medicare guidelines. **Compensation… more
- CenterWell (The Villages, FL)
- …Medicine or Geriatric Medicine preferred . Active and unrestricted DEA license . Medicare Provider Number . Minimum of two to five years directly applicable ... experience preferred . Experience managing Medicare Advantage panel of patients with understanding of Best...of home health services, and fourth largest pharmacy benefit manager , CenterWell is focused on whole-person health by addressing… more
- CenterWell (Wellington, FL)
- …for TB. **Preferred Qualifications** + Active and unrestricted DEA license + Medicare Provider Number/ Medicaid Provider Number + Experience managing Medicare ... care environment in a value-based relationship environment. + Knowledge of Medicare guidelines and coverage. + Knowledge of HEDIS quality indicators. **Additional… 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 ... issues with referring entities or providers that delay service delivery to manager . Provides excellent internal and external customer service by ensuring work meets… more
- CenterWell (Tampa, FL)
- …Medicine or Geriatric Medicine preferred . Active and unrestricted DEA license . Medicare Provider Number . Minimum of two to five years directly applicable ... experience preferred . Experience managing Medicare Advantage panel of patients with understanding of Best...of home health services, and fourth largest pharmacy benefit manager , CenterWell is focused on whole-person health by addressing… more
- CenterWell (Fort Lauderdale, FL)
- …Medicine or Geriatric Medicine preferred . Active and unrestricted DEA license . Medicare Provider Number . Medicaid Provider Number . Minimum of two to five ... years directly applicable experience preferred . Experience managing Medicare Advantage panel of patients with understanding of Best Practice in coordinated care… more
- Molina Healthcare (Tampa, FL)
- …Ownership** + Assists and executes tasks and projects to ensure Centers for Medicare & Medicaid Services (CMS) and State regulatory requirements are met for Pre-pay ... years of experience as a Business Analyst or Program Manager in a Managed Care Organization (MCO) or health...or health plan setting, including experience in Medicaid and/or Medicare , or equivalent combination of relevant education and experience… more