- University of Miami (Miami, FL)
- …staff position using the Career worklet, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . The ... budgets to assure charges are correct. + Prepare and submit amendments, continuing review reports, reportable events, case report forms and any other internal form… more
- Molina Healthcare (FL)
- …care fraud, waste, and abuse. Duties include performing accurate and reliable medical review audits that may also include coding and billing reviews. The SIU ... The position also entails producing audit reports for internal and external review . The position may also work with other internal departments, including Compliance,… more
- University of Miami (Miami, FL)
- …staff position using the Career worklet, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . The ... members, including participating in weekly project team meetings. + Review the status of projects and issues on an...and maintain Clinician's workflow and HEDIS quality measure for Medicare Advantage programs + Build and maintain CMS Quality… more
- Fresenius Medical Center (Crestview, FL)
- …the designated clinical application accurately and in a timely manner. + Review treatment sheets for completeness ensure nursing signatures are documented and ensure ... appointments + Weigh patient and obtain vital signs + Collect treatment records and review for completion. Notify RN of incomplete / missing records. + Cleaning and… more
- Prime Therapeutics (Tallahassee, FL)
- …and expansion products within the vendor suite of solutions + Responsible to review dashboard and provide timely reporting of all required metrics; validate accuracy ... problem identification and resolution, process improvements, compliance with Centers for Medicare & Medicaid Services (CMS) regulations, client issues and quality… more
- Acute Home Healthcare (Orlando, FL)
- …In-Office Case Manager primary responsibilities include but are not limited to: + Review of RN's OASIS Assessments to Ensure Completion and Accuracy + Record Case ... with Accuracy + Assist with Case Management including Draft Service Plans, Review Case Progress, Determine Case Closure + Facilitate Multiple care aspects including… more
- Prime Therapeutics (Tallahassee, FL)
- …data analyses, and the Request For Proposal (RFP) process + Lead, manage, and review data analyses, reporting, and projections + Lead, manage, and review ad ... work experience in a healthcare organization or PBM + Previous experience pricing Commercial, Medicare or Medicaid lines of businesses + 5 years of experience in SQL… more
- HCA Healthcare (Miami, FL)
- …and continued stay and discharge criteria. Orientation will also include Medicare and insurance benefits, grievance procedures, treatment plan process, and rights ... experience required + Certification in case management or utilization review preferred + InterQual experience preferred + 3 years...for our RN Case Mgr PRN opening. We promptly review all applications. Highly qualified candidates will be contacted… more
- HCA Healthcare (Miami, FL)
- …and continued stay and discharge criteria. Orientation will also include Medicare and insurance benefits, grievance procedures, treatment plan process, and rights ... nursing experience required + Certification in case management or utilization review preferred + InterQual experience preferred 3 years experience Required Years… more
- Humana (Tallahassee, FL)
- …looking is an experienced and well-grounded medical coding auditor to quality review the inpatient hospital claims for proper reimbursement, handle provider disputes ... you have a solid background in medical auditing, coding** **,** **and medical record review ?** **If** **you answered** YES **to one or more of the above** **,**… more