- Fresenius Medical Center (Jacksonville, FL)
- …the designated clinical application in an accurate and timely manner. + Review treatment sheets for completeness, ensure nursing signatures are documented, and ... **LICENSES:** + HighSchooldiplomaorG.E.D. required. + Must meet Center for Medicaid/ Medicare Services (CMS)-approved state and/or national certification requirements within… more
- Prime Therapeutics (Tallahassee, FL)
- …Qualifications** + Previous experience with RxClaim + Previous experience with Medicare or Medicaid Every employee must understand, comply with and attest ... ranges from $81,000.00 - $138,000.00 based on experience and skills. To review our Benefits, Incentives and Additional Compensation, visit our Benefits Page… more
- Molina Healthcare (FL)
- …with the standards and requirements established by the Centers for Medicare and Medicaid. **KNOWLEDGE/SKILLS/ABILITIES** + Enters denials and requests for appeal ... into information system and prepares documentation for further review . + Research issues utilizing systems and other available resources. + Assures timeliness and… more
- Insight Global (Miami, FL)
- …keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/. Skills ... field sales teams, agents and channel performance * Deep understanding of ACA, Medicare Advantage, and Life insurance distribution * Bilingual in English and Spanish… more
- CVS Health (Tallahassee, FL)
- …advocates for members who cannot advocate for themselves. The TOC team will review prior claims to address potential impact on current case management and ... (CKD), post-acute care, hospice, palliative care, cardiac, home health with Medicare members **Preferred Qualifications** + 4+ years of Licensed Practical Nurse… more
- Bristol Myers Squibb (Tampa, FL)
- …of a team responsible for accurate and timely Managed Care Commercial and Medicare Part D rebate processing and payments, data stewardship and compliance in ... deal structures to inform business, financial and government pricing calculation + Review and approve the monthly and quarterly Managed Care processes that support… more
- Bristol Myers Squibb (Tallahassee, FL)
- …strategies to drive performance and execution within the role + Develop, review , and modify Territory-level business plans ensuring alignment with national plans + ... governing rules and laws. + Possess a strong understanding of Commercial payers, Medicare plans and state Medicaid in geography. + Immunology experience (emphasis on… more
- Aveanna Healthcare (Punta Gorda, FL)
- …Documents effectively resulting in no technical or clinical denials subsequent to review of documentation by payers + Maintain effective communication between staff, ... Health Therapy and completion of OASIS documentation As an employer accepting Medicare and Medicaid funds, employees must comply with all health-related requirements… more
- Aveanna Healthcare (Holiday, FL)
- …Documents effectively resulting in no technical or clinical denials subsequent to review of documentation by payers + Maintain effective communication between staff, ... Health Therapy and completion of OASIS documentation As an employer accepting Medicare and Medicaid funds, employees must comply with all health-related requirements… more
- Humana (Tallahassee, FL)
- …in coordination with the beneficiary's physician and care team. + Coordinate, review , and approve medically necessary, appropriate care within the guidelines of the ... efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities at large. … more