- Oracle (Tallahassee, FL)
- …bring products to market quickly, navigate the regulatory pathway and negotiate payer reimbursement and coverage. KEY OUTCOMES As a Senior Research Consultant, you ... will: + Be the Principal Investigator, lead the design and execution of health outcomes studies including writing research proposals, designing questionnaires, overseeing statistical analysis plan (SAP) development, overseeing data analysis, providing… more
- Oracle (Tallahassee, FL)
- …closely with product, architecture, and domain experts to transform complex payer -provider processes into intelligent, automated systems. This role is critical to ... driving innovation, optimizing healthcare financial performance, and accelerating digital transformation across the health-tech landscape. **Responsibilities** Key Responsibilities + **Leadership and strategy** Define and drive the AI engineering vision,… more
- Robert Half Accountemps (Boca Raton, FL)
- …Proficiency in E/M coding and auditing principles. * Familiarity with Medicare claims, payer denials, and CPT codes. * Strong analytical skills and attention to ... detail in reviewing documentation and data. * Ability to communicate effectively with providers and administrative teams. * An associate degree from an accredited institution is preferred. * Experience with OB coding is a plus, though not mandatory. Robert… more
- University of Miami (Miami, FL)
- …Medicare Co-insurance and Advance Beneficiary Notices, and Medicare Secondary Payer Questionnaire. + Serves as gatekeeper, performs insurance verification, and ... obtains referrals and/or authorizations as needed. + Provides financial counseling services at check-in, explains benefits, creates estimates, and notifies patients of self-pay liabilities including co-pays, deductibles, co-insurances, global self-pay… more
- University of Miami (Miami, FL)
- …to ensure that the appropriate documents are obtained that are required to bill the payer . + Posts Medicaid and other 3rd party payments in the CMS Database system. ... + Processes refunds to Medicaid for Targeted Case Management and re-bills when errors are detected. + Inputs services into the State database for Children's Medical Services (CMS) data system. + Reviews Direct Services invoices processed by Medical Biller for… more
- Deloitte (Tampa, FL)
- …experience * Experience in Epic integration is preferred + Experience with Payer /Provider applications + Experience with ANSI transactions + Experienced in ITIL ... service methodology or Service NOW + Familiarity with HIPAA and other regulations + Basic knowledge of messaging formats used in healthcare integration (HL7, EDI, CSV, XML, etc.) + Experience working in the US health care domain and managed care setup +… more
- Select Medical (Niceville, FL)
- …business development team + Collect co-pays from patients, manage payer approvals, and conduct insurance authorizations and verifications **Qualifications** ... **Minimum:** + High School Diploma or GED + 1 Year Front Desk experience **Additional Data** _Equal Opportunity Employer/including Disabled/Veterans_ Apply for this job (https://jobs-selectmedicalcorp.icims.com/jobs/352636/medical-receptionist… more
- BayCare Health System (Clearwater, FL)
- …timely turnaround for authorizations. Utilize electronic scheduling/registration/financial systems, payer 's websites, and recorded calls to validate health coverage ... and benefits in processing approval for medical services. Maintain proper documentation in Soarian or GE systems. Work closely with Managed Care and understands health insurances rule sets, manuals, and contract language. **Why BayCare?** Our network consists… more
- University of Miami (Miami, FL)
- …capture best practices. Compliance & Documentation + Ensure adherence to payer guidelines, coding standards, and regulatory requirements. + Participate in internal ... audits and support external audit responses. + Maintain documentation of findings, recommendations, and resolutions. Reporting & Insights + Generate and analyze reports on revenue integrity KPIs. + Present findings to leadership and operational teams. +… more
- University of Miami (Miami, FL)
- …Medicare Co-insurance and Advance Beneficiary Notices, and Medicare Secondary Payer Questionnaire. + Serves as gatekeeper, performs insurance verification, and ... obtains referrals and/or authorizations as needed. + Provides financial counseling services at check-in, explains benefits, creates estimates, and notifies patients of self-pay liabilities including co-pays, deductibles, co-insurances, global self-pay… more