- Cardinal Health (Tallahassee, FL)
- …need for a better quality of life. Our diverse expertise in pharma, payer and hub services allows us to deliver best-in-class solutions-driving brand and patient ... appropriate sections of the database + Must track any payer /plan issues and report any changes, updates, or trends...upon by the client + Responsible for reporting any payer issues to the appropriate team + Must self-audit… more
- Cordis (Miami Lakes, FL)
- …are identified and addressed. The position requires a strong understanding of US payer systems and provider billing processes, and the ability to translate policy ... and internal stakeholders to identify trends in reimbursement performance and payer behavior. Translate insights into actionable strategies that inform pricing,… more
- AdventHealth (Altamonte Springs, FL)
- …benefits managers (PBMs), and healthcare organizations. This includes analyzing payer -specific formularies, terms, and conditions to align with the organization's ... for outpatient, specialty and ambulatory pharmacy contracts + Collaborates with payer and drug manufacturer partners to achieve the organization's outpatient,… more
- AdventHealth (Maitland, FL)
- …negotiation, review, and completion of assigned top-tier and mid-level tier payer contracts. Duties as assigned include leading strategic managed care contracting ... negotiation, reporting, implementation for assigned mid-level and top tier payer contracts; and issue resolution across multiple entities including hospitals… more
- Abbott (Orlando, FL)
- …patient refunds, and prepares documentation for internal, QC remediation, and external payer audits. The SME will support training and onboarding initiatives, assist ... + Prepare, validate, and submit patient refund packets in accordance with payer policies and company guidelines. + Develop and maintain internal documentation to… more
- AdventHealth (Orlando, FL)
- …the UM RN is responsible for denial avoidance strategies including concurrent payer communications to resolve status disputes. **The value you'll bring to the ... guidance based on available information. + Maintaining thorough knowledge of payer guidelines, familiarity with payer processes for initiating authorizations,… more
- AdventHealth (Tampa, FL)
- …the UM RN is responsible for denial avoidance strategies including concurrent payer communications to resolve status disputes. **The value you'll bring to the ... status guidance based on available information. Maintaining thorough knowledge of payer guidelines, familiarity with payer processes for initiating… more
- University of Florida (Alachua, FL)
- …and CPT codes, and confirming documentation compliance + Reviewing claim edits, payer denials, and reimbursement issues to provide timely feedback and education to ... faculty and staff + Researching coding updates and payer requirements to remain current with compliance standards + Delivering education and feedback on coding and… more
- Grifols Shared Services North America, Inc (Miami, FL)
- …business review analytics that effectively measure, track, and quantify changes payer /brand business segment, and competitor business patterns + Monitor and analyze ... industry, payer and customer trends, competitor pricing, and market conditions;...Skills & Abilities:** + Deep understanding of the US payer and market access environment and reimbursement methodologies +… more
- MyFlorida (Fort Pierce, FL)
- …to determine delivery of services. Ensures that any applicable hierarchy of payer sources is used appropriately. Screens for Medicaid eligibility, PAC Waiver ... Ensures Ryan White services are consistently used as the payer of last resort. Updates all required information regarding... of last resort. Updates all required information regarding payer source eligibility on his/her clients in the CAREWare… more