- 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
- Select Medical (Fort Walton Beach, 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 of Medical Office Experience **Preferred:** + Health care experience Apply for this job (https://jobs-selectmedicalcorp.icims.com/jobs/349889/medical-receptionist… more
- HCA Healthcare (Atlantis, 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
- Otsuka America Pharmaceutical Inc. (Tallahassee, FL)
- …+ Strong understanding of the US & Global healthcare landscape, including payer and policy environments + Excellent communication, leadership, and project management ... skills + Strong understanding of pharmaceutical compliance and regulatory frameworks + Excellent communication and interpersonal skills, with the ability to influence cross-functional teams + Strong analytical and problem-solving skills to address complex… more
- HCA Healthcare (Plantation, 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
- Molina Healthcare (Miami, FL)
- …provider disputes, appeals, and overpayment recoveries in a managed care or payer environment. + In-depth knowledge of medical and hospital claims processing, ... including CPT/HCPCS, ICD, and modifier usage. + Strong understanding of claim system configurations, payment policies, and audit processes. + Exceptional analytical, problem-solving, and documentation skills. + Ability to translate complex business problems… more
- HCA Healthcare (West Palm Beach, 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
- Lundbeck (Naples, FL)
- …to stay informed on reimbursement dynamics, anticipate and effectively address payer access issues (IDNs, Medicare, Medicaid, Commercial) using Lundbeck resources. ... **Pharmaceutical Environment/Compliance** - Apply knowledge of pharmaceutical and regulatory environment, including accountability and adherence to Lundbeck policies and procedures and FDA regulations regarding the promotion of pharmaceutical and medical… more
- BayCare Health System (Sarasota, FL)
- …clear concise referral provided to homecare division meeting all regulatory, payer , and safety requirements. + Completion of preadmission assessment and education ... to patient and caregiver of homecare services. + Coordination of Homecare and Pharmacy as well as communication with referral sources and physicians. + Responsible for knowledge of Medicare and Managed Care regulations and requirements. + Timely response to… more
- Datavant (Tallahassee, FL)
- …to ensure appropriate reimbursement and clinical severity for DRG-based payer patients. + Demonstrate understanding of complications, co-morbidities, severity of ... illness, risk of mortality, case mix index, secondary diagnoses, and procedure impact on DRG. + Improve coding specificity by educating physicians and caregivers on the importance of clear documentation throughout a patient's stay. + Follow AHA guidelines and… more
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