- BronxCare Health System (Bronx, NY)
- …collection, analysis, implementation of and compliance with risk management and claims activities, support of and participation in Continuous Quality Improvement ... (CQI) teams, consistent adherence to the specific rules and regulations of the BronxCare Health System (a) Safety and Security Policies, (b) Risk Management: Incident and Occurrence Reporting, (c) Infection Control Policies and Procedures and (d) Patient and… more
- Charles Settlement House (Rochester, NY)
- …Complete and distribute monthly calendars and newsletters to providers. + Submit monthly claims to Finance and CACFP. + Recruit and onboard new daycare providers. + ... Other job duties as assigned. Knowledge, Skill and Abilities + Working knowledge of current NYS Day Care and Child and Adult Care Food Program (CACFP) regulations. + Ability to interact with staff and consumers of diverse cultural, racial and ethnic… more
- Parsons Corporation (New York, NY)
- …Program Office and SEP teams to develop negotiation strategies andcoordinate responses to claims and change requests. + Review and support the approval process for ... Contractor-Initiated Change Order Requests (CICs),ensuring compliance with project objectives and contractual obligations. + Maintain version control and historical records of all approved changes, ensuring transparency andtraceability. + Provide input into… more
- Molina Healthcare (Albany, NY)
- …setting. **Required Experience** + 3 - 5 years customer service, provider service, or claims experience in a managed care setting. + 3-5 years' experience in managed ... healthcare administration and/or Provider Services. + 5 years' experience in provider contract negotiations in a managed healthcare setting ideally in negotiating different provider contract types, ie, physician, group and hospital contracting, etc. + Working… more
- City of New York (New York, NY)
- …systems and tools to support public health research and analysis to ensure claims submitted to the Grantors are accurate and timely. - Maintain research cost ... records submitted by programs, writes reports and prepares and conducts presentation on grant research costs. - Reviews documents to ensure that necessary entries are made. - Research the programmatic implications of proposed policies, including identifying… more
- Shinda Management Corporation (Queens Village, NY)
- …processing and reviewing EIV reports/corrections, repayment agreements, and process special claims + Pre-audit LIHTC/HUD and HOME tenant files for all properties ... including mixed-blended + Assist with preparation of site audits + Assist with the LIHTC portion of the rent ups + Assist with review of Certified Rent Rolls mid-year and at year end + Assist with preparation of Annual Owner Certifications + Tracking and… more
- Outreach Development Corporation (Richmond Hill, NY)
- …collection. + Managing the collection process, including follow-up on outstanding claims and patient balances, and resolution of billing/denial issues. + Analyzing ... billing and collections data to identify trends, potential issues, and opportunities for process improvement. + Working with HR and program management, to make sure that the staff, whose services the client is being billed for, are qualified and meet the… more
- Molina Healthcare (Buffalo, NY)
- …Medicare/MMP. + Analysis and reporting related to Managed care data like Medical Claims , Pharmacy, Lab and HEDIS rates. + Assist Quality department with HEDIS ... measure deep dive to support HEDIS audit and revenue at risk reporting. + Calculate and track HEDIS rates for all intervention outcome and for overall markets and LOB. + Work in an agile business environment to derive meaningful information out of complex as… more
- KPH Healthcare Services, Inc. (Ithaca, NY)
- …in the initial submission, and resubmission (as required) of all third party claims + Assist in the management of the pharmacy inventory, including transmitting, ... processing and receiving orders to the Kinney Warehouse and additional suppliers as needed + Assist in the checking of pharmacy inventory for outdates and processing all returns + Locating prescription files and other manual records from storage as needed +… more
- Northwell Health (Melville, NY)
- …to various government sites. + Manages work queue, aging lists, reports, and claims correspondence to assure accurate and timely payment of accounts. + Verifies ... completeness and accuracy of billing data and revises any errors. + Review and respond to third party, integrity, and special audits. + Ability to work in a fast-paced environment with demonstrated ability to prioritize multiple, competing tasks and demands,… more