- Surgery Care Affiliates (Tallahassee, FL)
- …Coverage guidelines in contacting patient's prior to the date of service to review , Physician Ownership, Advance Directives and Patient Rights. Authorization: + ... for a network of more than 370 ambulatory surgical centers, over 400 specialty physician practice clinics and numerous labs and surgical hospitals. Our work spans a… more
- HCA Healthcare (Sarasota, FL)
- …patient goals and maintain high quality patient care. Performs in accordance with physician 's orders and under the supervision of the Clinical Manager. **What you ... indicate continuing communication and coordination of services with the physician , other interdisciplinary team members and patient/family/caregiver. + Communicates… more
- HCA Healthcare (Sarasota, FL)
- …patient goals and maintain high quality patient care. Performs in accordance with physician 's orders and under the supervision of the Clinical Manager. **What you ... indicate continuing communication and coordination of services with the physician , other interdisciplinary team members and patient/family/caregiver. + Communicates… more
- HCA Healthcare (Sarasota, FL)
- …patient goals and maintain high quality patient care. Performs in accordance with physician 's orders and under the supervision of the Clinical Manager. **What you ... indicate continuing communication and coordination of services with the physician , other interdisciplinary team members and patient/family/caregiver. + Communicates… more
- AdventHealth (Maitland, FL)
- …quantify, and present contract compliance violations. He/she will perform extensive review of contract language, state and federal regulations, and payor practices ... This person demonstrates attention to detail and competencies in contract language review , research, decision support, and financial analysis in the preparation and… more
- Molina Healthcare (FL)
- …medical director, and quality improvement staff. + Facilitates conformance to Medicare , Medicaid, NCQA and other regulatory requirements. + Reviews quality referred ... requests in timely support of nurse reviewers; reviews cases requiring concurrent review , and manages the denial process. + Monitors appropriate care and services… more
- Evolent (Tallahassee, FL)
- …interacts with leadership and management staff, other Physicians, and staff whenever a physician `s input is needed or required. **What You Will Be Doing:** + Serve ... as the Physician match reviewer in Imaging cases, that do not...rationale for standard and expedited appeals. + Utilizes medical/clinical review guidelines and parameters to assure consistency in the… more
- HCA Healthcare (Pensacola, FL)
- …+ Work the unbilled alert and comp census reports daily. + Work the Medicare 72 hour and Medicaid 24 hour reports to identify Compliance overlapping accounts. + ... Transfer charges when appropriate. + Work all related Medicare APC edits that appear on the bill alert...HCA Healthcare's 186 hospitals and 2,400+ sites of care, Physician Services plays a crucial role as the main… more
- CVS Health (Tallahassee, FL)
- … review , diagnosis coding, and/or auditing. + Experience with Medicare and/or Commercial and/or Medicaid Risk Adjustment process and Hierarchical Condition ... records coded by internal teams prior to the submission to the Centers of Medicare and Medicaid Services (CMS) for the purpose of risk adjustment processes are… more
- HCA Healthcare (Davie, FL)
- …you will need:** + Two years of experience within a licensed and certified ( Medicare ) home health agency required + Competent in Federal ( Medicare ) and Local ... quality care during their recovery at home. We are Medicare certified. Our patients are under the supervision of...certified. Our patients are under the supervision of a physician and our team of professionals develop an individualized… more