- Trinity Health (Fort Lauderdale, FL)
- …abstracts data and ensure charges/coding are in alignment within AMA and Medicare coding guidelines. Ensure medical documentation and coding compliance with Federal, ... State and Private payer regulations. a. Perform coding functions, including CPT, ICD-10 assignment, documentation review and claim denial review b. Responsible for proofing daily charges for accuracy and clean claim submission c. Responsible for balancing… more
- Molina Healthcare (FL)
- …Directory (including ongoing execution, QA and maintenance of supporting tables), Medicare Provider Directory preparation, and FQHC/RHC reports. + Generates other ... provider-related reports, such as: claims report extractions; regularly scheduled reports related to Network Management (ER, Network Access Fee, etc.).; and mailing label extract generation. + Develops and maintains documentation and guidelines for all… more
- Wider Circle (Daytona Beach, FL)
- …phone or video conferencing. + A genuine interest in working with Medicare /DSNP/Medicaid populations and a commitment to building strong, supportive relationships. + ... Strong verbal and written communication skills to effectively engage with diverse community members. + Proactive approach to outreach, with the ability to take lead on community engagement initiatives. + Adaptability to a dynamic work environment and a… more
- Humana (Tallahassee, FL)
- …(DVACO) is an accountable care organization that participates in the Centers for Medicare and Medicaid Services' Medicare Shared Savings Program (MSSP), plus ... other commercial and Medicare Advantage value based programs. DVACO is a joint...Board + Leads strategic planning efforts to develop a specialist network within the ACO + Develops a health… more
- ChenMed (Largo, FL)
- …approved (when needed). + Schedules patient (Preferred Providers List of Specialist ) and notifies them of appointment information, including, date, time, location, ... and how patient was notified. + Referrals have been sent to specialist office & confirmed receipt. + Prepares and actively participates during physician/clinician… more
- ChenMed (Jacksonville, FL)
- …Checklist. + Communicates alternative/approvals to Referral Coordinator. + Follows up with MMD/ Specialist /MND if no response after 24hours. + Calls and follows up ... entered into HITS prospectively. + Works with tier2/tier 3 specialist to make sure our patients are seen working...the communities served by ChenMed, including the complexities of Medicare programs to patients in the healthcare marketplace +… more
- Molina Healthcare (Tampa, FL)
- …Ownership** + Assists and executes tasks and projects to ensure Centers for Medicare & Medicaid Services (CMS) and State regulatory requirements are met for Pre-pay ... Organization (MCO) or health plan setting, including experience in Medicaid and/or Medicare , or equivalent combination of relevant education and experience + Proven… more
- Banner Health (FL)
- …knowledge of clinical documentation and its impact on reimbursement under Medicare Severity Adjusted System (MS-DRG),All Payer Group (APR-DRG) and Ambulatory Payment ... and progressively responsible coding experience required. Requires Certified Coding Specialist (CCS) or Certified Inpatient Coder (CIC) or Certified Professional… more
- AdventHealth (Orlando, FL)
- …is knowledgeable in the areas of clinical trial budgets and protocols, Medicare coverage analysis, clinical trial financial processes including invoicing and time ... development conversations, leave, and workflow of the Clinical Trial Application Specialist team. + Cultivates a productive work environment. + Oversees work… more
- CVS Health (Tallahassee, FL)
- …applicable) to ensure the ICD codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) for the purpose of risk adjustment processes are ... + CPC (Certified Professional Coder) or CCS-P (Certified Coding Specialist -Physician) required. + Experience with International Classification of Disease (ICD)… more