- Molina Healthcare (Yonkers, NY)
- …Utilization Management and Long-Term Services & Supports issues. + Identifies and reports quality of care issues. + Prepares and presents cases in conjunction with ... specific programs supported by the plan such as Utilization Review , Medical Claims Review , Long Term Service...pharmacy, etc.). + Experience demonstrating knowledge of ICD-9, CPT coding and HCPC. + Experience demonstrating knowledge of CMS… more
- City of New York (New York, NY)
- …of Homeless Services (DHS). DSS-AO maintains the operation of the Office of Audit and Quality Assurance, Special Investigations Division (SID), Office of ... on the security of the software within the organization. Implement and govern automated secure coding tools and processes (SAST, DAST) to review code as it is… more
- New York State Civil Service (Orangeburg, NY)
- …and clinical services documentation for Medicaid funding. * Transcribing and coding medical, clinical, and mental health services.* Maintaining databases for ... staff on health information management requirements.* Conducting audits for utilization review activities and reporting deficiencies to the Utilization Review … more
- The Salvation Army (Syracuse, NY)
- …by researching account issues for compliance and by establishing quality control over financial transactions and financial reporting. Responsibilities ESSENTIAL ... assigned on an as needed basis to include: + Reviewing and approving invoice coding from the field + Complete all monthly bank reconciliations and other balance… more
- State of New York Mortgage Agency (New York, NY)
- …board and legislators + * Manage the implementation of any new A/P functions + * Review of randomly selected invoices to ensure quality control + * Support all ... and Treasury Services, Facilities and Building Management Services, Internal Audit , Project Management and Information Technology Services. OPS values professionals… more
- New York State Civil Service (Orangeburg, NY)
- …and clinical services documentation for Medicaid funding. * Transcribing and coding medical, clinical, and mental health services.* Maintaining databases for ... staff on health information management requirements.* Conducting audits for utilization review activities and reporting deficiencies to the Utilization Review … more
- Cardinal Health (Albany, NY)
- …patients can access, afford and remain on the therapy they need for a better quality of life. Our diverse expertise in pharma, payer and hub services allows us to ... interaction using the appropriate database for the inquiry + Self- audit intake activities to ensure accuracy and efficiency for...1-2 years of Pharmacy and/or Medical Claims billing and Coding work experience + 1-2 years experience with Prior… more
- University of Rochester (Rochester, NY)
- …surveys and audits. Designs and manages SharePoint and intranet website. Organize quality reports, review outcomes, and identify process improvements. Develops ... Manager will apply specialized clinical/medical knowledge regarding data definition, coding , and accreditation standards and best practices. Manages multiple… more
- SAIC (Westbury, NY)
- …ensure compliance with administrative procedures, rules, regulations, and statutes + Review the efficiency of administrative procedures within the office and ... to determine if all procedural requirements have been met + Calculate or audit timesheets, monitor instruction time and pay differential including a variety of… more