- CVS Health (Tallahassee, FL)
- …Sr 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 ... medical record documentation review, diagnosis coding, and/or auditing. + Experience with Medicare and/or Commercial and/or Medicaid Risk Adjustment process and… more
- Molina Healthcare (FL)
- …in accordance with the standards and requirements established by the Centers for Medicare and Medicaid Services (CMS). **Essential Job Duties** * Enters denials ... Qualifications** * Customer/provider experience in a managed care organization ( Medicaid , Medicare , Marketplace and/or other government-sponsored program), or… more
- MyFlorida (Tallahassee, FL)
- …the work unit, other areas of the Agency, and the Centers for Medicare and Medicaid Services. The individual: * Enters and retrieves licensure/certification, ... and planning entity. The Agency is responsible for administering the Florida Medicaid program, the licensure and regulation of nearly 50,000 health care facilities,… more
- Aveanna Healthcare (Fort Lauderdale, FL)
- …care to infants, children, adolescents, and adults. Note: As an employer receiving Medicare and Medicaid funds, Aveanna employees must comply with all ... become part of Aveanna's supportive and dynamic environment! As an employer accepting Medicare and Medicaid funds, employees must comply with all health-related… more
- CVS Health (Tallahassee, FL)
- …Experience or a willingness to thoroughly learn the role of care management within Medicare and Medicaid managed care. + Familiarity with community resources and ... coordination experience **Preferred Qualifications** + Experience providing care management for Medicare and/or Medicaid members + Experience working with… more
- Molina Healthcare (Orlando, FL)
- …Common Procedure Coding (HCPC). * Experience demonstrating knowledge of Centers for Medicare and Medicaid Services (CMS) guidelines, MCG, InterQual or other ... medically appropriate clinical guidelines, Medicaid , Medicare , CHIP and Marketplace, applicable state regulatory requirements, including ability to easily access… more
- Molina Healthcare (Tampa, FL)
- …with the standards and requirements established by the Centers for Medicare and Medicaid **KNOWLEDGE/SKILLS/ABILITIES** + Responsible for the comprehensive ... including coordination of benefits, subrogation, and eligibility criteria. + Familiarity with Medicaid and Medicare claims denials and appeals processing, and… more
- AdventHealth (Maitland, FL)
- …systems for Florida and multi-state hospital providers, with a concentration on Medicare , state specific Medicaid , non-contracted payers, and Tricare. Consults ... of governmental payer functions, regulations and payment methodologies and structure of Medicare , state Medicaid , Tricare and other government payers. Patient… more
- Aveanna Healthcare (West Palm Beach, FL)
- …+ Willingness to work an after-hours on-call schedule. Note:As an employer receiving Medicare and Medicaid funds, employees must comply with all health-related ... become part of Aveanna's supportive and dynamic environment. As an employer accepting Medicare and Medicaid funds, employees must comply with all health-related… more
- Aveanna Healthcare (Fort Lauderdale, FL)
- …in English; bilingual skills are a PLUS. Note: As an employer receiving Medicare and Medicaid funds, Aveanna employees must comply with all health-related ... become part of Aveanna's supportive and dynamic environment! As an employer accepting Medicare and Medicaid funds, employees must comply with all health-related… more