- Humana (Albany, NY)
- …by diverse resources which may include national clinical guidelines, CMS policies and determinations, clinical reference materials, internal teaching conferences, ... of decisions to internal associates, and possible participation in care management . The clinical scenarios predominantly arise from inpatient or post-acute care… more
- Elderwood (North Creek, NY)
- …maintenance to ensure a safe and welcoming environment. Proudly Rated 4 Stars by CMS ! Elderwood at North Creek has earned a 4-star rating from the Centers for ... Medicare and Medicaid Services ( CMS )-exceeding both the New York state average (3.33) and...the needs of the facility. + Utilizes electronic timekeeping system as directed. + Recognizes and follows the dress… more
- Rochester Regional Health (Rochester, NY)
- …Days SUMMARY: Review all inpatient medical necessity denials for the health system based on InterQual and/or CMS guidelines. Responsibilities include managing ... Job Title: Registered Nurse I Department: Utilization Management Location: Rochester General Hospital Hours Per Week:...review the denials that do not meet InterQual and/or CMS guidelines for his/her recommendation regarding appeal options. +… more
- MVP Health Care (Rochester, NY)
- …combination of education and experience. + At least 3+ years of enterprise-level content management experience. + Advanced proficiency in HTML, CSS, JavaScript, ... Lists, Azure DevOps, and Jira. + Update and maintain website content using Sitecore CMS , ensuring accuracy and brand alignment. + Collaborate with internal SMEs… more
- CTG (New York, NY)
- …and payment processing standards. + Work across multiple platforms, including CMS , eCommerce, CRM systems, cloud infrastructure, and CDN environments. + Collaborate ... Experience with databases and data integration. + Familiarity with cloud platforms, CMS , eCommerce, CRM systems, and CDN technologies. + Strong understanding of web… more
- Mount Sinai Health System (New York, NY)
- …+ In-depth knowledge of the coding process, coding systems software, workflow management , and excellent navigation of electronic medical records + Experience and ... working knowledge of various Health Insurance including CMS guidelines + Advanced knowledge of the ICD-10 CM/PCS...and billing rules + Previous experience with EPIC EMR system + Strong clinical and analytical skills to evaluate… more
- CTG (New York, NY)
- …and payment standards. + Integrate applications with various platforms, including CMS , eCommerce, CRM systems, Cloud infrastructure, and CDNs. + Troubleshoot and ... with both web and mobile application development. + Experience working with CMS , CRM, eCommerce platforms, Cloud infrastructure, and CDNs. + Demonstrated ability to… more
- ZOLL Medical Corporation (Mineola, NY)
- …sudden cardiac death. + HFMS (https://cardiacdiagnostics.zoll.com/products/heart-failure-arrhythmia- management - system /) (Heart Failure Management system ... CMS At ZOLL, we're passionate about improving patient...duties include selling the value of the ZOLL Patient Management System (ZPM) to clinicians as well… more
- Molina Healthcare (Rochester, NY)
- …average hold time are compliant with Centers for Medicare and Medicaid Services ( CMS ) regulations. * Ensures that adequate staffing coverage is present at all times ... for review. * Assures that activities and processes are compliant with CMS , National Committee of Quality Assurance (NCQA) guidelines, and Molina policies and… more
- CVS Health (Albany, NY)
- …codes that are submitted to the Centers for Medicare and Medicaid Services ( CMS ) for the purpose of risk adjustment processes are appropriate, accurate, and ... compliance with internal policies and procedures as well as regulatory guidance from CMS , OIG or other Regulatory body. **Required Qualifications** + Minimum of 1… more