- Option Care Health (Tallahassee, FL)
- …of authorization requests and follow up as needed + Ensure compliance with payer requirements and regulations + Utilize basic medical coding, diagnosis codes, and ... medical terminology in the authorization process + Maintain detailed records and documentation for all authorizations + Collaborate with billing and claims teams to resolve any authorization-related issues **Supervisory Responsibilities** Does this position… more
- HCA Healthcare (Tallahassee, FL)
- …thorough working knowledge of the rules of Medicare, Medicaid, and private payer regulations and processes. You will possess a thorough understanding of managed-care ... concepts and length-of-stay management relating to patient and organizational fiscal responsibility. + You will perform thorough assessments and develop appropriate discharge plans for high-risk patients with discharge planning or psychosocial needs. + You… more
- Aston Carter (Tampa, FL)
- …processes for cost reduction and revenue maximization while adhering to payer and regulatory guidelines. Responsibilities + Develop and maintain institutional ... performance dashboards to report actual performance against financial, process, and resource management goals. + Fulfill complex report requests from organizational leaders, requiring problem-solving and consulting skills. + Act as a system analyst to develop… more
- Trinity Health (Fort Lauderdale, FL)
- …a consultant and educator with medical staff regarding status, placement, payer requirements, and utilization of resources.** Assures appropriate sequencing of ... care/interventions for optimal results and smooth transition along hospital care and continuum.** Proactively identifies and removes barriers that impede the progress of care. Coordinates level of care appropriateness with admission status determination.**… more
- IQVIA (Orlando, FL)
- …existing contracts. + Represent the Managed Markets organization at priority national payer organizations (eg, AMCP, EMPAA) + Perform all company business in ... compliance and accordance with all state and federal regulations, and within Company policy and Procedures **REQUIRED KNOWLEDGE, SKILLS AND ABILITIES** + Demonstrated ability to develop, communicate, and implement successful strategic initiatives + Proven… more
- Grifols Shared Services North America, Inc (Gainesville, FL)
- …to utilize necessary internal resources to assist the customer (ie Director of Reimbursement, Payer Team, etc ) + Compliantly engage and interact with the MSL Team ... should a need arise **KAM Resources Utilization** + Maintain updated and accurate CRM Data + Build an Account focused Business Strategy in alignment with corporate strategies and goals utilizing available data resources + Lead and coordinate the Account… more
- Elevance Health (FL)
- …medical claims billing and payment systems, provider billing guidelines, payer reimbursement policies, and coding terminology preferred. For candidates working ... in person or virtually in the below location(s), the salary* range for this specific position is $81,852 to $155,088 Locations: California; Colorado; District of Columbia (Washington, DC), Illinois, New Jersey; Maryland, Minnesota, Nevada; New York; Washington… more
- University of Miami (Miami, FL)
- …trend analysis.6. Collaborates with relevant departments, agencies, insurance payer representatives, and vendors.7. Establishes and continuously assesses the ... effectiveness of the internal controls within the unit and compliance with University policies and procedures. Ensures employees are trained on controls within the function and on University policy and procedures.This list of duties and responsibilities is not… more
- AdventHealth (Davenport, FL)
- …to third party payers Monitoring receipt and distribution of third party payer requests and logs Assists with locating appropriate facilities for placement of ... patients moving to another level of care Facilitation of the transfer to alternate care facilities including transport arrangements Facilitating referrals for home care services Qualifications **The expertise and experiences you'll need to succeed** **:** High… more
- Insight Global (Jacksonville, FL)
- …- Efficiently uses available reference and coding tools and third party payer resources to research, maintain knowledge and provide feedback to department. - ... Eligible compensation range $25-$35 depending on experience. We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action… more