- Community Health Systems (Naples, FL)
- …Submits and processes claims accurately and efficiently, ensuring compliance with payer requirements and company policies. + Communicates with insurance companies, ... corrective actions. + Reviews and corrects claim filing edits based on payer requirements and electronic health record (EHR) system alerts. + Maintains accurate… more
- 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 ... a timely manner + Mediate effective resolution for complex payer /pharmacy issues toward a positive outcome to de-escalate +...appropriate sections of the database + Must track any payer /plan issues and report any changes, updates, or trends… more
- Butterfly Effects (Deerfield Beach, FL)
- …vital part in ensuring accurate, timely collection and resolution of outstanding payer balances while providing exceptional service to our families across the ... research and resolve denied or underpaid claims, and maintain compliance with payer guidelines and HIPAA regulations. This role requires a highly organized and… more
- Guidehouse (Tampa, FL)
- …through efficient review and timely resolution of assigned Medicare and third-party payer accounts that are subject to pre-bill claim edits, hospital billing ... + Maintains current knowledge of Medicare, Medicaid, and other third-party payer billing compliance guidelines and requirements. + Other duties commensurate with… more
- National Health Transport (Miami, FL)
- …National Health Transport Inc. billing processes. + File complaints with the appropriate payer or their governing authority. + Identify and separate denials by code ... and payer + Follow through with payers correspondence in a...+ Review account status routinely as required for each payer type; minimum of 20 days. + Identify recurring… more
- Cognizant (Tallahassee, FL)
- …with 20 to 24 years of expertise in Program Management, particularly in Healthcare Payer industry. The ideal candidate will manage and deliver complex projects in a ... impact on society. **Required Skills and Qualifications:** . US Healthcare Payer Delivery experience and domain expertise (20+ years). . Significant experience… more
- MyFlorida (Daytona Beach, FL)
- …oversight of care plans. Ensures Ryan White services are consistently used as the payer of last resort. Updates all required information regarding payer source ... eligibility on his/her clients in the FL RW Portal, CAREWare and HMS Databases within three business days. Completes and maintains accurate documentation of all client-specific activities. Case notes, scanned documents and all required information on clients… more
- Select Medical (Pensacola, FL)
- …an ICU or post-surgical stay by utilizing your strong clinical background, payer knowledge, and problem-solving skills. + Perform clinical assessments of referred ... to create a smooth pre-admission and transfer process through removing payer -related and operational barriers for patients getting into our highly effective… more
- University of Miami (Miami, FL)
- …resource availability, special needs, timeframes, medical necessity, and payer and contractual guidelines. Assists leadership with the management ... pathology, laboratory, and state/ federal regulations.11. Oversees the Medicare Secondary Payer Questionnaire (MSPQ) process in accordance with Centers for Medicare… more
- University of Miami (Miami, FL)
- …resource availability, special needs, timeframes, medical necessity, and payer and contractual guidelines. Oversees and clears patient work ... pathology, laboratory, and state/ federal regulations. + Completes the Medicare Secondary Payer Questionnaire (MSPQ) at time of scheduling prior to services being… more
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