- Elevance Health (Tampa, FL)
- …member of Elevance Health's family of brands. We administer government contracts for Medicare and partner with the Centers for Medicare and Medicaid Services ... federal health programs. The **Audit and Reimbursement II** will support our Medicare Administrative Contract (MAC) with the federal government (The Centers for … more
- Humana (Tallahassee, FL)
- …and other vendors. + Document all calls and requests. + Search for Medicare and Medicaid Guidelines. + Process all incoming fax/emails request for services the ... and/or ICD-10 codes. + Member service + Experience with Utilization Review and/or Prior Authorization, preferably within a managed care organization. **Additional… more
- DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
- …functions, including but not limited to, regulatory and D-SNP contract review and interpretation, periodic monitoring and auditing activities based on established ... with our business partners, the State Medicaid Office and/or the Centers for Medicare and Medicaid Services (CMS). The Compliance Manager will work closely with… more
- Humana (Tallahassee, FL)
- …in navigating multiple computer tools/systems/screens + 2+ years of Medicare customer service experience or sales experience (virtual/telephonic preferred) + ... Demonstrated ability to understand and explain Medicare benefits and address the unique needs of ...protection. Please be aware that applicants selected for leader review may be asked to provide their social security… more
- Intermountain Health (Tallahassee, FL)
- …HIM, PAS, and hospital finance staff as needed. + Prepares monthly Medicare and Medicaid settlement and policy reserve calculations using technically acceptable and ... and exception requests to appropriately maximize reimbursement. Interacts with Medicare Administrative Contractor, State Medicaid, and hospital personnel as needed.… more
- CVS Health (Tallahassee, FL)
- …**Key Responsibilities** : + Drafting and reviewing product filings: Draft Medicare Supplement and short-term limited duration health insurance products (policies, ... Stay abreast of changes in state and federal regulations related to Medicare supplement insurance. + Record Keeping: Maintain accurate records of product filings… more
- CenterWell (Tallahassee, FL)
- …several nurse practitioners or physician assistants, including completing regular chart review , coordinating monthly meetings, and being readily available to help ... * Meet with medical leader about quality of care, review of outcome data, policy, procedure, and records issues....Geriatric Medicine * Active and unrestricted DEA license * Medicare Provider Number * Medicaid Provider Number * Excellent… more
- Amgen (Orlando, FL)
- …through payer prior authorization to appeals/denials requirements and forms. + Review patient-specific information in cases where the site has specifically requested ... to HCPs on how the products are covered under the benefit design (Commercial, Medicare , Medicaid). + Serve as a payer expert for defined geography and promptly… 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 ... Acknowledgement of Receipt of Privacy Practices, Questionnaires, Important Message from Medicare , + Advance Directives Checklist, and answer any questions patients'… more
- MyFlorida (Spring Hill, FL)
- …Shares the responsibility of maintaining records of all providers Medicaid, Medicare , Unique Physician Identifier Number (UPIN), license and Drug Enforcement ... same. Independently communicates with clerks, clerical supervisors, and providers upon the review of CPT, Diagnostics and HMS Codes. Processes Medicaid, Medicare… more