- Datavant (Tallahassee, FL)
- …and educational needs related to coding quality, compliance assessments, external payer reviews, coding education, and coding workflow operations reviews. In this ... role, you will offer meaningful information tailored to exceed customer expectations, actively identifying and presenting solutions for customer issues. This role is fully remote with a flexible schedule, allowing you to help shape the future of healthcare… more
- Walgreens (St. Petersburg, FL)
- …order of importance and/or time spent)** + Submit timely, accurate invoices to payer for products and services provided. + Correctly determine quantities and prices ... for products and services billed. + Verify services and products are correctly authorized and required documentation is on file. + Ensure all Medicare documentation is received from the medical provider and submitted to Danville. + Review reports to maximize… more
- Merck (Tallahassee, FL)
- …stakeholders and their relative level of influence, referral dynamics, payer controls, patient demographics, specialty pharmacy activity, etc. + Understanding ... of access & insurance coverage processes in PAH, specifically those of payers most active in designated territory **Business Acumen:** + Ability to understand and define customer business models and infer strategic objectives + Ability to create account… more
- HCA Healthcare (Tallahassee, FL)
- …of Case Management Services + Makes appropriate referrals to third party payer disease and case management programs for recurring patients and patients with ... chronic disease states + Documents professional recommendations, care coordination interventions, and case management activities to effectively communicate to all members of the health care team + Facilitates patient throughput with an ongoing focus on quality… more
- HCA Healthcare (Tampa, FL)
- …performance driven, incentive plan driven, customer needs, identified trends, RAC, payer , etc.) for inpatient and/or outpatient coding (eg, DRG/code validation, ... query validation) + Provides timely feedback and education as it relates to coding opportunities found during the review of accounts + Ensures rebill requests are entered timely through the system/process outlined in company/HSC policy + Answers coding related… more
- BayCare Health System (Clearwater, FL)
- …levels of management. + This position is responsible for government payer reimbursement related to Medicare, Medicaid and TRICARE/CHAMPUS, specifically completion of ... the annual Medicare Cost report filings and audits, AHCA (Agency for Healthcare Administration) Florida Medicaid payment systems and staying current on all government regulatory changes and CMS/Federal and State proposals to change reimbursement methodologies… more
- BAYADA Home Health Care (Jacksonville, FL)
- …Participation, accreditation standards (eg, CHAP, ACHC, or Joint Commission), and payer requirements. + Assist with clinical quality and performance improvement ... initiatives (QAPI), infection control, patient satisfaction, and outcomes tracking. + Maintain continual survey readiness and lead the agency through state, CMS, and accrediting body inspections (eg, Joint Commission, CHAP, ACHC). + Ensure appropriate… more
- HCA Healthcare (Ocala, FL)
- …the established chain of command + Makes appropriate referrals to third party payer , disease and case management programs for recurring patients and patients with ... chronic disease states + Facilitates patient throughput with an ongoing focus on an effective care transition, quality and efficiency + Documents professional recommendations, discharge plan, care coordination interventions, and case management activities to… more
- HCA Healthcare (Kissimmee, FL)
- …the established chain of command. + Makes appropriate referrals to third party payer and disease and case management programs for recurring patients and patients ... with chronic disease states. + Facilitates patient throughput with an ongoing focus on an effective care transition, quality, and efficiency. + Documents professional recommendations, discharge plan, care coordination interventions, and case management… more
- LogixHealth (Dania Beach, FL)
- …of A/R follow-up experience in professional healthcare billing + Familiarity with payer regulations, claims appeals processes, and denial reasons + Proficiency in ... EHR and billing systems and clearinghouse portals + Prior word processing, spreadsheet, and internet software experience including p roficiency with MS Teams, Word, Excel, and Outlook + Excellent written and verbal communication skills Preferred: + Experience… more