• Referrals Supervisor

    ChenMed (Miami, FL)
    …the center referral staff (care coordinators) at the request of the Center Manager and provides feedback to Center Managers when needed. + Ensures Preferred Provider ... is used accurately and effectively. Collaborates with referral management to ensure specialist network is adequate for the geography and escalates accordingly when… more
    ChenMed (10/28/25)
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  • Associate Medical Director

    CenterWell (Jacksonville, FL)
    …indicators (KPIs), such patient experience via Net Promoter Score (NPS) and Medicare clinical quality via HEDIS, meeting local and organizational goals + Personally ... primary care including health promotion & prevention, disease management, effective specialist & hospital co-management, and complex care management + Spend 20-30%… more
    CenterWell (11/21/25)
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  • Ops Senior Clerk

    MyFlorida (Naples, FL)
    …other billing functions. This position reports to the TB PROGRAM MANAGER -NURSING PROGRAM SPECIALIST . Your Specific Responsibilities: Medical Billing: Performs ... clients and representatives from 3rd party insurance companies, Medicaid, and Medicare for the verification of insurance and coverage. Additionally, this position… more
    MyFlorida (11/14/25)
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  • RN UM Clinical Appeals Nurse Remote

    Molina Healthcare (Orlando, FL)
    …**Preferred Qualifications** * Certified Clinical Coder (CCC), Certified Medical Audit Specialist (CMAS), Certified Case Manager (CCM), Certified Professional ... Procedure Coding (HCPC). * Experience demonstrating knowledge of Centers for Medicare and Medicaid Services (CMS) guidelines, MCG, InterQual or other medically… more
    Molina Healthcare (11/14/25)
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  • LVN Delegation Oversight Nurse Remote

    Molina Healthcare (Tampa, FL)
    …**Preferred Qualifications** + Certified Clinical Coder (CCC), Certified Medical Audit Specialist (CMAS), Certified Case Manager (CCM), Certified Professional ... compliance with the National Committee for Quality Assurance (NCQA), Centers for Medicare and Medicaid Services (CMS), state Medicaid entity requirements and all… more
    Molina Healthcare (11/13/25)
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  • Network/Provider Rep.

    ChenMed (Clearwater, FL)
    …opportunities within the CPL. + Responsible for meeting with high volume community specialist at least monthly to give them feedback on their referring trends and ... + Performs other duties as assigned and modified at manager 's discretion. KNOWLEDGE, SKILLS AND ABILITIES: + Advanced-level business...related field is required + Healthcare experience within the Medicare HMO population is a plus + A valid,… more
    ChenMed (09/25/25)
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  • Accountant III-Health Insurance Billing

    MyFlorida (Largo, FL)
    …Tool (https://compcalculator.myflorida.com/) ACCOUNTANT III - HEALTH INSURANCE BILLING SPECIALIST FLORIDA DEPARTMENT OF VETERANS' AFFAIRS Agency Headquarters, Mary ... receivables functions to maintain the billing. + Process monthly billing for all Medicare A&B, Medicaid, Medicaid Managed Care, Third Party Insurers, and any other… more
    MyFlorida (11/25/25)
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  • Facility Inpatient Complex Senior Coder

    Banner Health (FL)
    …initial training by both the Banner Coding Education team and your hiring manager , with continued support throughout your career here! _**_ _This position is for ... documentation to coding support tech, coding quality analyst or coding manager for clarification/additional information for accurate code assignment. 3. Provides… more
    Banner Health (10/17/25)
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  • Oncology Sales Representative - Birmingham

    Merck (Tallahassee, FL)
    …with the in-scope customer team: Customer Team Leader, Key Account Manager , Nurse Educator, Field Reimbursement Associate, Medicare Account Executive, ... **Job Description** **Oncology Sales Representative / Specialist ** Grow and accelerate your career with our...plans in collaboration with the local team and district manager (known as the Oncology Customer Team Leader). +… more
    Merck (11/22/25)
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  • Advanced Practice Registered Nurse - Medicine,…

    University of Miami (Miami, FL)
    …or specialty continuing education course; serv ing as resource /super-user/ specialist /support ; teaches specialty competency development and proctor skill validation ... NPI, prior to employment start date and meet current Medicare requirements for billing Experience: + M inimum of...supervisor and Elias Fernandez, APRN, and Sr. Clinical Practice Manager ) and the faculty on service to have the… more
    University of Miami (11/12/25)
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