- HCA Healthcare (St. Petersburg, FL)
- …+ You will maintain a thorough working knowledge of the rules of Medicare , Medicaid, and private payer regulations and processes. You will possess a thorough ... you to apply for our Social Worker MSW PRN opening. We promptly review all applications. Highly qualified candidates will be contacted for interviews. **Unlock the… more
- Humana (Tallahassee, FL)
- …meet required timelines. + Submits required documents to state agencies for review and approval. + Regularly meet with Humana Healthy Horizons Medicaid markets ... efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities at large. … more
- Humana (Tallahassee, FL)
- …across our tax accounting operations. **Key Responsibilities** + Lead the preparation, review , and analysis of the company's quarterly and annual income tax ... efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities at large. … more
- CenterWell (Tallahassee, FL)
- …services. Able to navigate healthcare options; care services post-acute offerings, Medicare coverage, billing issues, as well as accessing healthcare resources. + ... Health, Hospice, and Palliative Care Services. + Assist with clinical eligibility review for alternate services + Participates in special projects and performs other… more
- MyFlorida (Delray Beach, FL)
- …and holidays. This position requires successful completion of all Center for Medicare Services (CMS) Quality, Safety & Education Portal (QSEP) training for Life ... listening, interview procedures, writing skills, team dynamics, and methods of documentation review . Ability to plan and organize to ensure timely completion of… more
- University of Miami (North 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 ... and sensitivity to each patient's individual situation. + Possess knowledge of Medicare , Medicaid, and various third party requirements. + Ability to accurately… more
- Cognizant (Tallahassee, FL)
- …with UB/institutional (CMS-1450) and/or professional (CMS 1500) claims * Knowledge of Medicare / Medicaid payment and coverage guidelines and regulations. * 1 year of ... * Experience in the analysis and processing of claims for payments, utilization review /quality assurance procedures. * Must be able to work with minimal supervision.… more
- Polaris Pharmacy Services, LLC (Fort Lauderdale, FL)
- …Research, analyze and appropriately resolve rejected claims by working with national Medicare D plans, third party insurance companies, and all state Medicaid plans ... limited to prior authorizations forms and manual billing in a timely manner + Review and work convert billing exception reports to ensure claims are billed to… more
- Bristol Myers Squibb (Tampa, FL)
- …of a team responsible for accurate and timely Managed Care Commercial and Medicare Part D rebate processing and payments, data stewardship and compliance in ... deal structures to inform business, financial and government pricing calculation + Review and approve the monthly and quarterly Managed Care processes that support… more
- DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
- …adjusting claims and other duties as necessary. Key Responsibilities: + Review , research, analyze and process professional claims by navigating multiple applications ... preferably + Medical terminology + Computer literacy + Knowledge of current Medicare Advantage operational and regulatory guidelines established by CMS, AHCA and… more