- 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
- CVS Health (Tallahassee, FL)
- …records coded by internal teams prior to the submission to the Centers of Medicare and Medicaid Services (CMS) for the purpose of risk adjustment processes are ... record documentation review, diagnosis coding, and/or auditing. + Experience with Medicare and/or Commercial and/or Medicaid Risk Adjustment process and Hierarchical… more
- 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
- CenterWell (Deerfield Beach, FL)
- …for this role, you will be required to be screened for TB. ** Preferred Qualifications:** Active and unrestricted DEA license Medicare Provider Number/ Medicaid ... advanced practice professionals, Pharm D, Care Coach Nurse, MA, Behavioral health specialist , Quality based Coder, Referral Coordinator and more. Our approach allows… more
- Ensono (Miami, FL)
- …US Citizenship and pass related background checks including but not limited to Medicare and Medicaid and VA ** Preferred Skills:** + Experience with secure ... policies, regulatory requirements, and industry best practices. The IAM Specialist will also be responsible for maintaining all necessary certifications… 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
- Molina Healthcare (Tampa, 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 (St. Petersburg, FL)
- …and verbal communication skills including ability to synthesize complex information. ** PREFERRED QUALIFICATIONS:** + Experience with Medicare , Medicaid, and ... achieve operational goals and executes tasks and projects to ensure Centers for Medicare & Medicaid Services (CMS) and State regulatory requirements are met for… more
- ChenMed (Miami, FL)
- …Manager and provides feedback to Center Managers when needed. + Ensures Preferred Provider List is used accurately and effectively. Collaborates with referral ... management to ensure specialist network is adequate for the geography and escalates...experience/understanding + Understanding of cost as it relates to Medicare parts A, B and D + Proficient in… more
- 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