- Constructive Partnerships Unlimited (Manhattan, NY)
- …REQUIREMENTS: 1. Minimum BA/BS in related Human Services Field. 2. Must be a certified investigator or be able to pass the certification course within 60 days of ... Incident Management Investigator Type of Position Full time Search Location(s)...code of business conduct, the NYS and federal false claims acts, whistleblower protections and mandatory reporting. Completes corporate… more
- Molina Healthcare (Rochester, NY)
- **JOB DESCRIPTION** **Job Summary** The Special Investigation Unit (SIU) Investigator is responsible for supporting the prevention, detection, investigation, ... review audits that may also include coding and billing reviews. The SIU Investigator is responsible for reviewing and analyzing information to draw conclusions on… more
- Elevance Health (Latham, NY)
- ** Investigator Senior** **Supports the Payment Integrity line of business** **Hybrid 1** : This role requires associates to be in-office **1-2** days per week, ... to recover, eliminate and prevent unnecessary medical-expense spending. The ** Investigator Senior** is responsible for the independent identification, investigation… more
- EFI Global (Syracuse, NY)
- …and RESPONSIBILITIES** **Accepts assignments from customers for investigation of losses or claims and pursues investigation in accordance with the specific needs of ... the assignment.** **Determines the origin and cause of the loss/ claim under investigation and identifies any potential third-party responsibility for subrogation… more
- Mount Sinai Health System (New York, NY)
- …Receivable, Charge Entry, Edits and Payment Posting. This individual facilitates claims processing and payments services rendered by physicians and assists with ... analysis and problem resolution to ensure accurate and timely payment of claims and collection. The Specialist works directly with the Department Administrator.… more
- Mount Sinai Health System (New York, NY)
- …Proficient in these processes to ensure accurate and timely payment of claims and collection, and in analysis and problem resolution. **Qualifications** + Associates ... of relevant experience + Certified coder required + Experience in medical billing or health claims , with experience in EPIC & IDX billing systems in a health care or… more
- Mount Sinai Health System (New York, NY)
- …Proficient in these processes to ensure accurate and timely payment of claims and collection, and in analysis and problem resolution. **Qualifications** + Associates ... + 3 years experience in medical billing or health claims , with experience in IDX billing systems in a...encounter forms for accuracy. May be responsible for obtaining pre- certification for scheduled surgeries and admissions. + Enters office,… more
- Mount Sinai Health System (New York, NY)
- …pharmacy experience preferred. English proficiency, oral and written. **Licensing and Certification Requirements (if applicable) ** Valid New York State Pharmacy ... system. 2. Data analysis: such as payer data and claim 3. Support the pharmacist to implement the patient's...and in the 99th percentile in research dollars per investigator according to the Association of American Medical Colleges.… more
- Mount Sinai Health System (Elmhurst, NY)
- …School Diploma. Knowledge of Medical Terminology, ICD-9CM, ICD-10CM and CPT 4 coding certification obtained by completion of a certificate course with CPC / CCS-P ... accounts receivable team to ensure the time processing of claims and all revenue is captured. Maintains daily logs...classes, seminars or trainings to keeping current with CPC certification . Reviews, modifies and recommends changes to policies and… more