- Prime Therapeutics (Tallahassee, FL)
- …monitor aspects of compliance and validate policies, procedures, support and review of member/provider communications, manuals and materials. This role supports the ... or PBM organization, or other highly regulated industry, including experience with Medicare , Medicaid, and the Affordable Care Act (ACA) + Must be eligible… more
- CenterWell (Jupiter, FL)
- …coordination with local food bank) and health care providers (eg, coordinate visits, review annual wellness visits, and education materials, and engage people on the ... follow up appointments, alleviating social isolation + Participate in interdisciplinary review of and coordination around complex patients + Maintain patient… more
- Aveanna Healthcare (Crystal River, 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
- Molina Healthcare (Doral, 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
- HCA Healthcare (Sarasota, FL)
- …Description + Works with team members in billing, revenue integrity and/or the Medicare Service Center to resolve alerts/edits + Communicates coding revisions to the ... II (CIS-II) duties + Periodically works with their Manager to review individual work accomplishments, discuss work problems/barriers, discuss progress in mastering… 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
- Robert Half Office Team (Deltona, FL)
- …patient referrals to specialty services, ensuring accuracy and timeliness. * Review and complete daily administrative reports, including incomplete tasks and no-show ... Excel, Word, and PowerPoint. * Experience in a healthcare setting, particularly with Medicare Advantage plans, is preferred. * Bilingual proficiency in Spanish is a… more
- HCA Healthcare (Hudson, FL)
- …the preparation of the annual financial reports including but not limited to: Medicare Cost Report, work paper package and the AHCA prior year report package. ... Company policies and procedures. + You will assist in the preparation, coordination, review , and compilation of the capital and operating budgets for all entities. +… more
- Fresenius Medical Center (Port St. Lucie, 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
- Humana (Tallahassee, FL)
- …care fraud investigations (Medical Coding or Healthcare (Medical Chart Review /Insurance Billing) or Internal/External Audit or Regulatory/Compliance OR Claims ... efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities at large. … more