- Evolent (Tallahassee, FL)
- …in a services-oriented organization. + Strong demonstrated understanding of provider, and payer personas, 'jobs to be done' and practice workflows, with a preference ... with scrum and agile methodologies. + Proven experience working closely with Payer customers is required. + Experience with Lean/Six Sigma or other process… more
- Oracle (Tallahassee, FL)
- …delivery through powerful, AI-driven workflow innovation. Our Autonomous Reimbursement, Payer , and Interoperability teams are developing advanced solutions to ... technical program management efforts across mission-critical projects in RevenueCycle, Payer , and Interoperability domains. + Design, implement, and continuously… more
- Community Health Systems (Naples, FL)
- …Provides education and updates to staff on workflow changes, system functionality, payer requirements, or regulatory updates. + Participates in the development and ... multiple stakeholders and departments. + Familiarity with healthcare regulations, payer requirements, and privacy standards. + Proficiency in registration software… more
- Cardinal Health (Tallahassee, FL)
- …with federal and state regulations and laws, CMS and other third-party payer billing rules and internal documentation, coding and billing policies and procedures. ... subject matter expert and authoritative resource regarding federal, state and payer documentation, billing and coding rules and regulations, maintaining awareness of… more
- HCA Healthcare (Bradenton, FL)
- …of hospital's peer review committees as requested. Business Development and Payer Relations + Evaluates clinical appropriateness of new medical technologies and ... and consultant to hospital case managers and hospital staff in the reduction of payer denials and in the denial and appeals process, as requested by the Case… more
- Select Medical (Tampa, FL)
- …of Revenue Cycle Management is mandatory. + Act as a gatekeeper of payer information, communicate updated payer information to facilities as needed; create ... facility reference tools for "top ten payors" for the market. Communicate regularly with the Contracting department to stay informed of any new changes or requirements involving payors. + Perform as a market liaison, an extension of the CBO. Develop… more
- Select Medical (Lutz, 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 + Health care experience **Preferred:** + Bilingual + Insurance Verification Experience **Additional Data** _Equal Opportunity Employer/including Disabled/Veterans_ Apply for this job… more
- AssistRx (Orlando, FL)
- …+ Create cohesive question sets using specific questions provided by the payer . + Create cohesive question sets using specific information provided by clinical ... staff. + Create workflows in proprietary systems. + Comply with privacy and security standards, and applicable data and security requirements. Requirements + Knowledge of prescription drug reimbursement including: insurance plan types, major medical benefits… more
- Centene Corporation (Tallahassee, FL)
- …management activities to ensure compliance with current state, federal, and third-party payer regulators + Provides and/or facilitates education to members and their ... families/caregivers on disease processes, resolving care gaps, healthcare provider instructions, care options, referrals, and healthcare benefits + Provides feedback to leadership on opportunities to improve and enhance care and quality delivery for members in… 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