- Excellus BlueCross BlueShield (Rochester, NY)
- …investigating and remediating allegations of FWA while adhering to compliance and regulatory requirements. Primary activities include substantiating referrals, case ... contracts, group benefit structures, Corporate Medical Policies, the AMA CPT Coding Guidelines, HCPCS coding , inter-plan regulations, government policies, as… more
- Northwell Health (Glen Head, NY)
- …Corporate Compliance Program, HIPAA and other regulatory standards; ensures compliance related to billing, coding , and documentation standards; executes the ... key functions are handled in an accurate and timely manner); ensures strict compliance with internal controls for cash management. 6.Engages workforce to obtain high… more
- Tutor Perini (New York, NY)
- …issuance of owner monthly progress report + Accurate Quantities documented on timecards and compliance with project cost coding structure + Management of all T&M ... you will have the opportunity to: + Reviewing project schedule for compliance for subcontractor onboarding process + Creating and issuing subcontractor commitments… more
- Highmark Health (Albany, NY)
- …clinical outcomes, cost, and member experience. + **Operational Integration & Coding :** Engage non-clinical teams to ensure operational guidelines are aligned with ... intent. Develop and maintain a thorough understanding of medical coding (ICD-10, CPT, HCPCS) and ensure accurate coding... coding (ICD-10, CPT, HCPCS) and ensure accurate coding principles are incorporated into policy criteria. + **Policy… more
- MTA (New York, NY)
- …and to develop the technical specification and necessary documentation in compliance with MTA procedures. Critical Skills Required: + Strong hands-on experience ... in a timely manner. + Assist less experienced software developers/analysts in solving coding and technical issues related to MTA software. Level 4 Same as Level… more
- Intermountain Health (Albany, NY)
- …and stays current on CMS, federal and state regulations, payor guidelines, ensuring compliance and alignment with charge, coding and charge edits. + Audits ... maintenance of consistent charge capture or charge edits to ensure regulatory compliance and revenue optimization for assigned service line(s). This position will… more
- Highmark Health (Albany, NY)
- …and demographic data, interpret and apply diagnoses and procedures utilizing ICD coding systems and assists in decreasing the average accounts receivable days. ... management of medical information and cash flow as it pertains to the unbilled coding report. (10%) + Keeps informed of the changes/updates in ICD guidelines by… more
- Mount Sinai Health System (New York, NY)
- …elements include data entry, database management, data validation, injury coding and scoring, statistical data analysis; report design; supporting administrative, ... and research initiatives. Collaborates closely with trauma program leadership to ensure compliance with the State of New York trauma regulations, American College of… more
- Catholic Health Services (Smithtown, NY)
- …while simultaneously improving the quality of care and ensuring compliance with regulatory standards. Key Responsibilities: Clinical Reimbursement: + Documentation: ... purposes, including Minimum Data Set (MDS) assessments and other relevant documentation. + Coding and Billing: Assist in the accurate coding and billing of… more
- Cognizant (Albany, NY)
- …on **ICD-10-CM** (International Classification of Diseases) and **PCS** (Procedure Coding System) standards. . **Responsibilities** + Review clinical documentation ... query process. + Utilize electronic encoder applications to assign codes in compliance with practice policies and regulatory guidelines. + Maintain a minimum… more