- Veterans Affairs, Veterans Health Administration (Miami, FL)
- …(CAAs) that are assigned to nursing, adhering to current Centers for Medicare and Medicaid Services (CMS) and Veterans Health Administration (VHA) timeframes of ... of RAI/MDS assessments and CAAs reported during the interrater reliability review . Engages in professional organizations to enhance leadership and career growth.… more
- CVS Health (Tallahassee, FL)
- …to identify and submit ICD codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) for the purpose of risk adjustment processes are ... of 1 year recent and related experience in medical record documentation review , diagnosis coding, and/or auditing. + Completion of AAPC/AHIMA training program for… more
- Insight Global (St. Petersburg, FL)
- …this person will be responsible for data collection from health plans related to Medicare or commercial insurance coverage. This role is crucial by acting as the ... we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/ . Skills… more
- CenterWell (Tallahassee, FL)
- …actual and proposed medical care and services against established CMS Coverage Guidelines/NCQA review criteria and who is interested in being part of a team that ... + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/ Medicare + Current nursing experience in Hospital, SNF,… more
- HCA Healthcare (Fort Walton Beach, FL)
- …with the patient, including having the Patient Choice letter signed. + Monitors Medicare patient's planned discharge dates and delivers the Important Medicare ... you to apply for our Case Management Assistant opening. We promptly review all applications. Highly qualified candidates will be contacted for interviews. **Unlock… more
- Humana (Tallahassee, FL)
- …Prior experience in provider education + Strong knowledge of medical record review + Understanding of billing, claims submission, and related processes + Proficient ... is higher. **Preferred Qualifications** + Bachelor's Degree + Previous experience in Medicare Advantage or Value-Based Care + AAPC CRC (Certified Risk Adjustment)… more
- HCA Healthcare (Pensacola, FL)
- …+ Work the unbilled alert and comp census reports daily. + Work the Medicare 72 hour and Medicaid 24 hour reports to identify Compliance overlapping accounts. + ... Transfer charges when appropriate. + Work all related Medicare APC edits that appear on the bill alert...to apply for our Billing Specialist opening. We promptly review all applications. Highly qualified candidates will be contacted… 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 ... HIPAA Notice of Privacy, No Surprise Billing, Good Faith Estimate, Off Campus Medicare Co-insurance and Advance Beneficiary Notices, and Medicare Secondary Payer… more
- AdventHealth (Orlando, FL)
- …record, applying appropriate ICD-10-CM/PCS coding conventions and MS-DRG Medicare Prospective Payment System requirements. Actively participates in outstanding ... to all. The Senior Coder demonstrates experience and expertise, so coding quality review is not required before billing. The Senior Coder utilizes years of… more
- CenterWell (Tallahassee, FL)
- …actual and proposed medical care and services against established CMS Coverage Guidelines/NCQA review criteria and who is interested in being part of a team that ... Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/ Medicare /Medicaid Experience a plus + Current nursing… more