- Molina Healthcare (St. Petersburg, FL)
- …and request any missing information. * Updates credentialing software systems with required information. * Requests recredentialing applications from providers ... necessary for processing of recredentialing applications. * Reviews claims payment systems to determine provider status, as necessary. * Completes follow-up for… more
- Modernizing Medicine (Tampa, FL)
- …Chile, and Germany. ModMed (https://www.modmed.com/company/) is hiring a driven Patient Claim Specialist who will play a pivotal role in shaping a positive patient ... and update patient account information and document calls into the Practice Management system + Special Projects: Other duties as required to support and enhance our… more
- AdventHealth (Altamonte Springs, FL)
- …the medical record, applying appropriate ICD-10-CM/PCS coding conventions and MS-DRG Medicare Prospective Payment System requirements. Actively participates in ... ICD-10-CM rules and conventions, coding policy and procedures, requirements of Medicare / payer specifications, and official coding guidelines as outlined by… more
- Wider Circle (Palm Coast, FL)
- …lifestyles. + Advocate for member and community needs within healthcare systems and social services. + Establish partnerships with community-based organizations to ... care. + Support individuals in understanding and navigating the healthcare system . + Organize workshops and informational sessions on healthcare topics. +… more
- 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, ... of Ambulatory Payment Classification (APC), and Outpatient Prospective Payment System (OPPS) reimbursement structures and pre-bill edits including Outpatient Coding… more
- Molina Healthcare (FL)
- …on all claims and provider databases. Staff ensure adherence to business and system requirements of internal customers as it pertains to other provider network ... Directory (including ongoing execution, QA and maintenance of supporting tables), Medicare Provider Directory preparation, and FQHC/RHC reports. + Generates other… more
- Ensono (Miami, FL)
- …(CMS) security standards and compliance requirements. + Experience with Fiscal Intermediary Shared System (FISS), Medicare Claims System (MCS), Clerk ID, ... Senior Systems Engineer - IAMRemote - United StatesJR012224 At...policies, regulatory requirements, and industry best practices. The IAM Specialist will also be responsible for maintaining all necessary… more
- AdventHealth (Altamonte Springs, FL)
- …nursing, and care management. This includes quarterly compliance updates from Medicare . + Effectively and appropriately communicates with physicians and other ... Department experience. . Two (2) years of Clinical Documentation Specialist experience **LICENSURE, CERTIFICATION OR REGISTRATION REQUIRED:** . Current active… 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...among three stakeholders: Humana (majority owner), Main Line Health System , and Jefferson Health System . Humana takes… more
- ChenMed (Jacksonville, FL)
- …approved (when needed). + Schedules patient (Preferred Providers List of Specialist ) and notifies them of appointment information, including, date, time, location, ... patient was notified. + Referrals have been sent to specialist office & confirmed receipt. + Prepares and actively...with the ability to navigate proficiently through computer software systems + Team-oriented with the ability to work extremely… more