• Member Engagement Specialist

    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. + ... hours) and reliable transportation when necessary. + 3-5 years relevant experience. Preferred Requirements + Associate or Bachelor Degree + 3+ years of relevant… more
    Wider Circle (07/31/25)
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  • Referral Coordinator

    ChenMed (Jacksonville, FL)
    …5 days. + Orders have been approved (when needed). + Schedules patient ( Preferred Providers List of Specialist ) and notifies them of appointment information, ... with Web IVRs and obtaining referrals/authorizations for multiple payers strongly preferred + Healthcare experience within the Medicare Advantage population… more
    ChenMed (09/16/25)
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  • Referral Coordinator

    ChenMed (North Miami Beach, FL)
    …5 days. + Orders have been approved (when needed). + Schedules patient ( Preferred Providers List of Specialist ) and notifies them of appointment information, ... with Web IVRs and obtaining referrals/authorizations for multiple payers strongly preferred + Healthcare experience within the Medicare Advantage population… more
    ChenMed (10/14/25)
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  • Supervisor, Referrals

    ChenMed (Lakeland, 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...experience/understanding + Understanding of cost as it relates to Medicare parts A, B and D + Proficient in… more
    ChenMed (09/27/25)
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  • Referrals Team Supervisor - Broward County

    ChenMed (North Lauderdale, 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
    ChenMed (07/29/25)
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  • Facility Coding Inpatient DRG Coding Quality Acute

    Banner Health (FL)
    …coding (clearly reflected in uploaded resume);** + **DRG and PCS experience preferred ;** + **Bachelors degree in HIMS or equivalent experience;** + **Certified ... knowledge of clinical documentation and its impact on reimbursement under Medicare Severity Adjusted System (MS-DRG),All Payer Group (APR-DRG) and Ambulatory Payment… more
    Banner Health (10/16/25)
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  • Lead Analyst, Payment Integrity - REMOTE

    Molina Healthcare (Orlando, FL)
    …and verbal communication skills including ability to synthesize complex information. ** PREFERRED QUALIFICATIONS:** + Experience with Medicare , Medicaid, and ... Ownership** + Assists and executes tasks and projects to ensure Centers for Medicare & Medicaid Services (CMS) and State regulatory requirements are met for Pre-pay… more
    Molina Healthcare (09/28/25)
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  • Patient Referral Coordinator

    ChenMed (Tamarac, FL)
    …5 days. + Orders have been approved (when needed). + Schedules patient ( Preferred Providers List of Specialist ) and notifies them of appointment information, ... and how patient was notified. + Referrals have been sent to specialist office & confirmed receipt. + Prepares and actively participates during physician/clinician… more
    ChenMed (10/16/25)
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  • Prior Authorization Technician - Remote

    Polaris Pharmacy Services, LLC (Fort Lauderdale, FL)
    …Remote Position Type Full Time Job Category Pharmaceutical Description PRIOR AUTHORIZATION SPECIALIST (REMOTE) WHO WE ARE Polaris Pharmacy Services is an industry ... Authorization Technicians to join the Polaris team. OVERVIEW The Prior Authorization Specialist is responsible for managing and identifying a portfolio of rejected… more
    Polaris Pharmacy Services, LLC (10/11/25)
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  • Coding Data Quality Auditor

    CVS Health (Tallahassee, FL)
    …CDQA) to ensure the ICD-10 codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) for the purpose of risk adjustment processes are ... Qualifications** + CPC (Certified Professional Coder) or CCS-P (Certified Coding Specialist -Physician). + CRC (Certified Risk Adjustment Coder) must be able to… more
    CVS Health (10/16/25)
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