- AdventHealth (Tampa, FL)
- …within the EPIC management billing system to ensure successful claim submission. Monitor payer rejects and denials to determine systemic or data entry issues and ... report irregularities to management. Maintains knowledge of third-party payor reimbursement guidelines and managed care contracts. Responsible for receiving and addressing accounts within 72 hours of being routed to the claims edit work queue and coding review… more
- Northwest Florida Community Hospital (Vernon, FL)
- …practices of patient registration, insurance reimbursement, governmental and other payer source billing, credit and collections, cashiering and admitting; familiar ... with functions, capabilities and operation of computer based billing, patient accounts, and registration management systems. Supervised by: Clinic Physician, ARNP and the Practice Manager Supervises (Headcount): Supervises (Job titles): For Direct Patient Care… 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
- BayCare Health System (Clearwater, FL)
- …requirements. + Ensure compliance with Medicare, Medicaid, and other third-party payer guidelines specific to SNF settings. **Requirements:** + CCC-SLP (Speech ... Language Pathology) + BLS (Basic Life Support) + Speech Therapy License + Required Master's Speech Therapy + 1 year Clinical Related is preferred **Facility:** BayCare Health System, Speech Therapy-MP REHAB **Location:** **Morton Plant Rehab Center, Bellaire… more
- HCA Healthcare (Kissimmee, 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
- HCA Healthcare (Tamarac, FL)
- …as an educational resource to patients, families, interdisciplinary team members, payer representatives, and other parties as appropriate about behavioral services. ... + Reviews, coaches, and helps with the training of new staff/interns as assigned within approved practice and program guidelines. Participates in developing department goals and clinical programming. + Performs utilization review as assigned. + Helps with… more
- ChenMed (Pembroke Pines, FL)
- …+ Prescribes medication and treatment in accordance with patient condition, payer coverage/guidelines and industry standards. + Reviews PCP requests for external ... cardiology referrals and participates in delegated utilization authorizations; determines level of urgency of follow-up, referral/consultation appointments. + May have responsibility for cardiology clinical operations of 2-5 centers in the market, under the… more
- University of Miami (Miami, FL)
- …care continuum that includes interacting with consulting physicians, third party payer and other health care providers to facilitate movement of the ... patient through the system and arrangement of an appropriate discharge plan. + Works collaboratively with the multidisciplinary staff to design and implement treatment plans and discharge plans for the patient. + Be able to provide appropriate referrals… more
- AdventHealth (Maitland, FL)
- …Scorecards and incentive check validation and distribution. + Oversees payer -specific performance programs, integrating applications and management into operational ... workflows. + Guide the team in creating and implementing strategies to involve medical practices in value-based care models including action plan management of providers requiring performance improvement enhancements, ensuring alignment with organizational… more
- Elevance Health (FL)
- …design and execution of Value Based Payment Models strongly preferred + Prior Payer experience. For candidates working in person or virtually in the below ... location(s), the salary* range for this specific position is $116,256 to $199,296. Locations: Woodland Hills, CA; Denver, CO; District of Columbia (Washington, DC); Chicago, Il; Iselin, NJ; Hanover, MD; Mendota Heights, MN; Las Vegas, NV; New York City, NY;… more