- Molina Healthcare (FL)
- …Company's assigned contact to log tickets for premium restoration such as Medicare Secondary Payer and ESRD. **JOB QUALIFICATIONS** **Required Education** HS Diploma ... or GED **Required Experience** 1-3 years' experience in an administrative support. **Preferred Education** Associate degree **Preferred Experience** 3+ years' experience in an administrative support role. To all current Molina employees: If you are interested… more
- Elevance Health (Tampa, FL)
- … of complex exception requests and CMS change requests. + Perform supervisory review of workload involving complex areas of Medicare part A reimbursement ... Health's family of brands. We administer government contracts for Medicare and partner with the Centers for Medicare...experienced associates as assigned. + Prepare and perform supervisory review of cost report desk reviews and audits. +… more
- Humana (Tallahassee, FL)
- …help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing home health, SNF, DME, dual Medicare ... of services provided by other healthcare professionals in compliance with review policies, procedures, and performance standards. All work occurs with a… more
- Humana (Tallahassee, FL)
- …help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing home health, SNF, DME, dual Medicare ... of services provided by other healthcare professionals in compliance with review policies, procedures, and performance standards. All work occurs with a… more
- BAYADA Home Health Care (Jacksonville, FL)
- …experienced and compassionate **Director** to manage operations at our **Jacksonville, FL Medicare -certified Home Health office** . The ideal candidate will have a ... strong background in healthcare administration, regulatory compliance ( Medicare Conditions of Participation), clinical coordination, and business operations. This… 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
- BayCare Health System (Clearwater, FL)
- …Within the Team:** + Analyze government reimbursement data and develop strategies for Medicare /Medicaid Cost Reports + Prepare and review annual cost reports and ... ensure regulatory compliance + Monitor federal and state reimbursement changes and assess financial impact + Support net revenue analysis, forecasting, and reserve methodology + Collaborate with cross-functional teams in Finance, Revenue Cycle, and Accounting… more
- Intermountain Health (Tallahassee, FL)
- **Job Description:** Provides assistance to the Reimbursement Manager to control or review the following areas for government and third party payers for assigned ... appropriately recorded, reviewed, and reconciled. Reviews or prepares monthly Medicare and Medicaid contractual allowance calculations using technically acceptable… more
- Molina Healthcare (Miami, FL)
- …achieve operational goals and executes tasks and projects to ensure Centers for Medicare & Medicaid Services (CMS) and State regulatory requirements are met for ... with a consistent focus on promoting the quality, accuracy, and efficiency of review services. + Serve as a resource and subject matter expert to colleagues… more
- University of Miami (Coral Gables, FL)
- …1 ( Medicare Billing Coding & Financial) works independently to review internally and externally sponsored clinical research, including agreements and proposals, ... faculty or staff position using the Career worklet, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . The Office of… more