- Humana (Tallahassee, FL)
- …Senior Business Intelligence Engineer will develop and maintain expertise in complex Medicare reimbursement methodologies. This role is within the Integrated ... on Pricer edit resolution + Provide consultation to internal business partners on Medicare reimbursement /editing logic and Humana system logic **Use your skills… more
- Molina Healthcare (Tampa, FL)
- …their financial and clinical performance is achieving desired results + Keep abreast of Medicaid and Medicare reforms and their impact on Molina Healthcare **JOB ... and manage information from large data sources. + Analyze claims and other data sources to identify early signs...- 5 years supervisory experience + Demonstrated understanding of Medicaid and Medicare programs or other healthcare… more
- Danaher Corporation (Orlando, FL)
- …and reimbursement landscape. + Communicate regional and local coverage and reimbursement issues for Medicare , Medicaid and Commercial payers through ... and reimbursement . + Support customers with approved resources for denied claims , payer coverage expansion and inadequate reimbursement . + Respond to and… more
- Danaher Corporation (Orlando, FL)
- …and maintain a comprehensive understanding of national, regional and local coverage and reimbursement issues for Medicare , Medicaid and Commercial payers ... and reimbursement . + Support customers with approved resources for denied claims , payer coverage expansion and inadequate reimbursement . + Respond to and… more
- Humana (Tallahassee, FL)
- …certification from the AAPC and/or AHIMA) + Extensive knowledge of medical claims processing and familiarity with reimbursement methodologies, ICD, CPT, and ... efforts are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large.… more
- Molina Healthcare (St. Petersburg, FL)
- …and troubleshooting. **Job Duties** + Research, review, and decipher state-specific Medicaid and Medicare reimbursement methodologies for providers, ... or reimbursement processes + Experience processing or reviewing facility claims + Prior professional experience utilizing Microsoft Excel (eg, performing basic… more
- Guidehouse (Tampa, FL)
- …regarding compliance, and reimbursement under outpatient grouping systems such as Medicare OPPS and Medicaid or Commercial Insurance EAPG's. + Knowledge and ... various types of authoritative information. + Maintains current knowledge of Medicare , Medicaid , and other third-party payer billing compliance guidelines… more
- MyFlorida (Tallahassee, FL)
- …informed about the operations of the Medicaid fiscal agent, including Medicaid claims process, billing procedures, reimbursement methodologies, encounter ... submissions, and provider enrollment. * Remain informed about Medicare policies, national Medicaid /CHIP-related research and demonstration projects, Medicaid… more
- MyFlorida (Tallahassee, FL)
- …informed about the operations of the Medicaid fiscal agent, including Medicaid claims processing, billing procedures, reimbursement methodologies, and ... 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
- Polaris Pharmacy Services, LLC (Fort Lauderdale, FL)
- …Specialist is responsible for managing and identifying a portfolio of rejected pharmacy claims to ensure maximum payer reimbursement and timely billing to ... + Manage and identify a portfolio of rejected pharmacy claims to ensure maximum payer reimbursement and...their customers + Research, analyze and appropriately resolve rejected claims by working with national Medicare D… more