- Northwell Health (Melville, NY)
- **Req Number** 174298 Job Description Reviews and responds to Corporate Compliance Audits and serves as a resource for the Health System. Reviews denial trends and ... identifies coding issues and knowledge gaps. Job Responsibility + Serves...level of care decisions and billing status and ensures compliance with the Utilization Review standard and regulations. +… more
- Northwell Health (Melville, NY)
- **Req Number** 176310 Job Description Reviews and responds to Corporate Compliance Audits and serves as a resource for the Health System. Reviews denial trends and ... identifies coding issues and knowledge gaps. Job Responsibility Serves as...level of care decisions and billing status and ensures compliance with the Utilization Review standard and regulations. Performs… more
- Humana (Albany, NY)
- …service should be authorized. All work occurs with a context of regulatory compliance , and work is assisted by diverse resources which may include national clinical ... require conflict resolution skills. Some roles include an overview of coding practices and clinical documentation, grievance and appeals processes, and outpatient… more
- Scotiabank (New York, NY)
- …business strategies and objectives. Ensures all activities conducted are in compliance with governing regulations, internal policies and procedures. **What You'll ... reports for approval and payment, ensuring timely completion and proper client coding . Prepares and submits invoices to Accounts Payable for processing. Follows up… more
- Oracle (Albany, NY)
- …and enhance business processes to improve efficiency, scalability, and compliance . + **Business Operations Execution** : Drive critical business operations ... Management and Engineering to improve SLAs and mitigate risk, ensure regulatory compliance , and advance operational integrity. Serve as a trusted partner for… more
- Oracle (Albany, NY)
- …by design," including strong authentication/authorization, secrets management, and compliance -minded development. + Mentor peers, perform code/design reviews, and ... and code quality while adhering to Oracle's security, privacy, and compliance standards. **Minimum Qualifications:** + 15+ years of software engineering experience,… more
- Nuvance Health (Poughkeepsie, NY)
- …management. Receives incoming faxed physician orders. Verifies orders for compliance and accuracy.4.Performs insurance eligibility verification and executes payer ... to calculate estimate of patient liabilities. Requires an understanding of coding , procedural protocols and the charge description master. 5.Initiates requests for… more
- Humana (Albany, NY)
- …at the Inpatient level. All work occurs within a context of regulatory compliance , and work is assisted by diverse resources, which may include national clinical ... with an external provider. Some roles include an overview of coding practices and clinical documentation, dispute/grievance and appeals processes, and outpatient… more
- Humana (Albany, NY)
- …service should be authorized. All work occurs within a context of regulatory compliance , and work is assisted by diverse resources, which may include national ... may require conflict resolution skills. Some roles include an overview of coding practices and clinical documentation, dispute, grievance, and appeals processes, and… more
- National Health Care Associates (Poughkeepsie, NY)
- …for services provided. You will ensure the highest level of revenue integrity and compliance to all state and federal regulations for MDS completion and coding ... conventions. **Key Responsibilities:** + Lead and oversee the MDS program, ensuring compliance and accuracy in assessments + Determine Patient Driven Payment Method… more