- AdventHealth (Maitland, FL)
- …for Florida and multi-state providers. Precision of the contract build ensures payer accountability and compliance to the negotiated contract rates and terms and ... affords AdventHealth leadership the foundation for reporting and determining overall payer performance and allows AdventHealth the ability to accurately model… 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
- HCA Healthcare (Tampa, FL)
- …CCU and company coding policies, and monitor governmental and commercial payer information for complete, accurate and consistent code assignments. The CQR ... + Inform CQR Leadership of any significant issues (eg, education process issues, payer issues, vendor issues, etc.). + Stay informed and relay any unique coding… more
- AdventHealth (Maitland, FL)
- …will have expertise in Commercial and Governmental (Medicare, Medicaid, Tricare) payer reimbursement language and methodologies. The Senior Compliance Analyst works ... contracts for potential revenue opportunities and contract violations for all payer types. + Analyze, understand, and articulate regulatory and contractual… more
- AdventHealth (Altamonte Springs, FL)
- …in A/R and increase clean claims rate + Performs peer-to-peer discussions with payer Medical Directors and/or discusses cases with payer representatives to ... facilitate claim resolution and build payer relationships + Collaborates with Chief Medical Officers and acts as a liaison between contracted Managed Care/Commercial payors related to managed care denials, Care Management and the Hospitals Medical Staff +… more
- HCA Healthcare (Orange Park, FL)
- …cause of the denial/downgrade + Explanation of Benefits/Remittance Advice + Payer denial/DRG downgrade letters + Complex NCD/LCD guidelines, CMS/AHCA policies and ... Association, Food and Drug Administration, Medicare Administrative Contractors and payer websites + Escalates problem accounts/processes/trends and report opportunities… 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
- Cardinal Health (Tallahassee, FL)
- …practice. Managed Care oversees the interactions that take place between payer and provider(s) to ensure optimal reimbursement including managed care contracting, ... credentialing, and any other activity as it relates to payer interaction. Manager of Payor Contracting is responsible for...using knowledge of market, local and national benchmarks, and payer market. Key member of negotiating team for company.… more
- AdventHealth (Altamonte Springs, FL)
- …collaboration to meet prescribed deadlines. Examines contracts, and learns payer contracts to understand reimbursement methodology to appropriately reconcile patient ... proper billing, collections, or denial management on patient accounts. Depending on payer contract may be required to participate in conference calls, review… more
- Griswold Home Care, Inc (Tampa, FL)
- …the form of compensation. You get paid directly by your client or a third party payer . Set up Direct Deposit and you could have your money directly in your account ... the form of compensation. You get paid directly by your client or a third party payer . Set up Direct Deposit and you could have your money directly in your account… more
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