- MyFlorida (Orlando, FL)
- …that all verbal orders, including telephone orders from attending physicians, are reviewed by a registered nurse . + If no RN is available, receive all ... reflective of resident's status, and providing supervision and guidance to the Registered ( RN ), Licensed Practical Nurse (LPN), Certified Nursing… more
- Molina Healthcare (Orlando, FL)
- …to health care fraud, waste, and abuse. Duties include performing accurate and reliable medical review audits that may also include coding and billing reviews. ... nursing experience with broad clinical knowledge. + Five years experience conducting medical review and coding/billing audits involving professional and facility… more
- Molina Healthcare (Orlando, FL)
- …Managed Care Experience in the specific programs supported by the plan such as Utilization Review , Medical Claims Review , Long Term Service and Support, ... appeals outcomes within compliance standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse ( RN ) performs clinical/ medical reviews of… more
- Acute Home Healthcare (Orlando, FL)
- …Elements of Oasis Documentation + Medicare Programs (Home Health Value Based Purchasing, Pre- Claim Review ) + CMS and Other Regulatory Resources + Home Healthcare ... Job description An Acute Home Healthcare Nurse Educator serves as a role model, and...& Training Field Nurses (as needed) + Clinical Chart Review + QAPI: Quality Assurance / Performance Improvement Analysis… more