- Humana (Tallahassee, FL)
- …efforts are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. ... reviewing criteria to ensure appropriateness of care preferred + Previous Medicare experience a plus + Milliman MCG experience preferred **Additional Information**… more
- University of Miami (Miami, FL)
- … Secondary Payer Questionnaire (MSPQ) process in accordance with Centers for Medicare & Medicaid Services (CMS) Federal regulations.12. Reviews and processes ... information with discretion, maintaining confidentiality of all laboratory information according to laboratory policy.13. Supervises the daily activities of the Laboratory Accessioner personnel. Seeks feedback from the team and physicians in identifying… more
- University of Miami (Miami, FL)
- …of scheduling prior to services being rendered and in accordance with Centers for Medicare & Medicaid Services (CMS) Federal regulations, as needed. + Reviews ... and processes information with discretion, maintaining confidentiality of all laboratory information according to laboratory policy. + Adheres to University and unit-level policies and procedures and safeguards University assets. This list of duties and… more
- Humana (Tallahassee, FL)
- …efforts are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. ... Certified Risk Coder (CRC) + Experience interacting with healthcare providers + Medicare Risk Adjustment knowledge + Analyzing data to build unique education… more
- Humana (Tallahassee, FL)
- …efforts are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. ... + SAS and/or Databricks experience + Programming experience in SQL and VBA + Medicare Part D knowledge Travel: While this is a remote position, occasional travel to… more
- Humana (Tallahassee, FL)
- …efforts are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. ... 2+ years SQL experience, or equivalent skillset **Preferred Qualifications** + Medicare Advantage background + Creative, high degree of self-accountability +… more
- Insight Global (Boca Raton, FL)
- …on regulations such as HIPAA, Stark Law, the Anti-Kickback Statute, Medicare / Medicaid , and third-party payor requirements; addressing AI and cybersecurity ... law firm Demonstrated expertise in HIPAA, Stark Law, Anti-Kickback Statute, Medicare , and third-party payor/health plan issues Technology AI and cybersecurity… more
- Evolent (Tallahassee, FL)
- …under current exclusion or sanction by any state or federal health care program, including Medicare or Medicaid , and is not identified as an "excluded person" by ... Human Services or the General Service Administration (GSA), or reprimanded or sanctioned by Medicare . . No history of disciplinary or legal action by a state medical… more
- Humana (Tallahassee, FL)
- …efforts are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. ... focused on continuously improving consumer experiences **Preferred Qualifications** + Medicare Advantage experience + Strong Communication Skills + Ability to… more
- Humana (Tallahassee, FL)
- …efforts are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. ... improving consumer experiences **Preferred Qualifications** + Health insurance experience + Medicare Advantage experience Travel: While this is a remote position,… more