- CenterWell (Deland, FL)
- …audits/billing are completed timely and in compliance with Medicare regulations. + Coordinates communication between team members/attending physicians/caregivers ... + Assesses staff education needs based on own the review of clinical documentation in addition to feedback and...documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and… more
- Molina Healthcare (Tampa, FL)
- …care fraud, waste, and abuse. Duties include performing accurate and reliable medical review audits that may also include coding and billing reviews. The SIU ... also entails producing audit reports for internal and external review . The position may also work with other internal...+ Knowledge of Managed Care and the Medicaid and Medicare programs as well as Marketplace. + Understanding of… more
- Fresenius Medical Center (Lakeland, FL)
- …the designated clinical application accurately and in a timely manner. + Review treatment sheets for completeness ensure nursing signatures are documented and ensure ... appointments + Weigh patient and obtain vital signs + Collect treatment records and review for completion. Notify RN of incomplete / missing records. + Cleaning and… more
- Datavant (Tallahassee, FL)
- …vision for healthcare. As an Auditor, HCC Risk Adjustment Coder, you will review medical records to identify and code diagnoses using a standardized system, ensuring ... + Proficient in ICD-10 coding. + Experienced in HCC coding across Medicare , commercial, and Medicaid sectors. + In-depth knowledge of medical terminology,… more
- University of Miami (Fort Lauderdale, FL)
- …or staff position using the Career worklet, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . Core Job ... + Assists in monitoring staff productivity and quality of work through proactive review of key performance indicators. + Serves as functional expert resource and… 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 ... the Division of Rheumatology. + Draft of original correspondence for Chief Review and signatory (eg letter of recommendations, letters to editors, letters responding… 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 ... members, including participating in weekly project team meetings. + Review the status of projects and issues on an...and maintain Clinician's workflow and HEDIS quality measure for Medicare Advantage programs + Build and maintain CMS Quality… more
- AssistRx (Maitland, FL)
- …change. + Performs document control functions, including tracking, processing, review , formatting, distribution, and archiving of documents. + Evaluate document ... checks before document finalization. + Assists the Compliance Manager in the review and management of third-party audits. + Verifies compliance with insurer rules,… more
- Molina Healthcare (St. Petersburg, FL)
- …HCS Department staff workload for adherence to the Policies, Procedures, Guidelines, Medicare Model of Care, and deadlines. Assures oversight and direction of ... timely completion. + Actively participates in the Department auditing program to review and communicate findings with staff and identify opportunities for improved… more
- MyFlorida (Largo, FL)
- …receivables functions to maintain the billing. + Process monthly billing for all Medicare A&B, Medicaid, Medicaid Managed Care, Third Party Insurers, and any other ... payer for the State Veterans' Homes. + Review and monitor resident accounts ensuring that the account...established by the facility. + Verify insurance eligibility. + Review and monitor accounts on a daily basis to… more