- Elevance Health (Miami, FL)
- ** Audit & Reimbursement Senior - Appeals ** **_Location:_** _This role enables associates to work virtually full-time, with the exception of required ... and Medicaid Services to transform federal health programs._ The ** Audit and Reimbursement Senior ** will...report reopenings. + Manage caseload of Medicare cost report Appeals + Position papers + Jurisdictional Reviews + PRRB… more
- Bristol Myers Squibb (Tampa, FL)
- …ad-hoc inquiries, as well as ensuring the timely completion of audit requests and providing necessary information for compliance, audits, contract management, ... designed; supports the implementation and adherence to SOX controls and compliance, audit activities as needed, ensures compliance for all plan documents and… more
- CHS (Clearwater, FL)
- …One core service, claims administration, is where submissions for payment/ reimbursement /sharing from medical providers and covered individuals are reviewed, subject ... as transparency in reporting results, trends and issues to Senior Management and clients. * Management of relationships with...Examiner queues waiting to be adjudicated, and in either audit or needing approval status. * Developing and implementing… more
- Baylor Scott & White Health (Tallahassee, FL)
- …hospital and professional clinical and coding denials, as well as Recovery Audit Contractors (RAC) denials. This role will be responsible for developing and ... to improve appeal success rates, ensure regulatory compliance and optimize reimbursement outcomes. Will lead external resources through vendor or contractor… more