- Elevance Health (Tampa, FL)
- …Skills, Capabilities, and Experiences:** + 1-3 years experience in claims processing, provider , or credentialing strongly preferred. For candidates working in ... **Network Data Specialist I** is responsible for accurate and timely maintenance of provider information on claims and provider databases. **How You Will Make… more
- Humana (Tallahassee, FL)
- …a part of our caring community and help us put health first** The Medical Director relies on broad clinical expertise to review Medicare drug appeals (Part D ... & B). The Medical director work assignments involve moderately complex to complex...Director will collaborate with clinicians and support staff to provide Humana members with optimal value based care in… more
- Veterans Affairs, Veterans Health Administration (Gainesville, FL)
- …overall Credentialing programs to include both the Licensed Independent Provider (LIP) and Dependent (non-LIP) Sections. The physician serves as subject-matter ... as secondary supervisor. The incumbent serves as Chief of Credentialing and Privileging. Ideal applicants are those who want...restriction on moonlighting The Associate Chief of Staff for Medical Staff Affairs is responsible for the management and… more
- University of Miami (Miami, FL)
- …a key role in supporting cardiology recruitment efforts and section medical directors by coordinating interviews, preparing recruitment materials, greeting and ... escorting candidates, processing reimbursements, and maintaining recruitment and credentialing records. This role requires strong organizational skills, attention to… more
- Humana (Tallahassee, FL)
- …a part of our caring community and help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing home ... health, SNF, DME, dual Medicare/Medicaid and Waiver requests. The Medical Director provides medical interpretation and determinations whether services provided… more
- Humana (Tallahassee, FL)
- …a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to make ... reference materials, internal teaching conferences, and other reference sources. Medical Directors will learn Medicare and Medicare Advantage requirements, and… more
- Humana (Tallahassee, FL)
- **Become a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The ... situations or data requires an in-depth evaluation of variable factors. The Medical Director provides medical interpretation and decisions about the… more
- Wellpath (Pompano Beach, FL)
- …and care continuity. + **Documentation** : Maintain accurate, timely documentation in medical records, adhering to all legal, credentialing , and program ... **Perks and Benefits** In addition to comprehensive benefits including medical , dental, vision, paid time off, and 401k, we...and responsibility to show up with non-judgmental compassion to provide hope and healing to those who need it… more
- HCA Healthcare (Port Charlotte, FL)
- …Do you want to join an organization that invests in you as a Medical Insurance Claims Specialist? At Parallon, you come first. HCA Healthcare has committed up ... and retirement of our colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no cost or for a low… more
- KBR (Fort Walton Beach, FL)
- …do not have clear precedents. + Under the supervision of a credentialed provider , conduct intakes, assist with care and treatment of psychiatric, drug and alcohol ... required forms for new patients on behalf of the licensed mental health provider . + Collect and maintain monthly statistical data assigned work place. + Conduct… more