- Spectrum Health and Human Services (Orchard Park, NY)
- …on a monthly/quarterly basis. + Monitor corrective action plan (CAP) progress, track compliance , and ensure timely follow-up on audit findings. + Support ... in achieving compliance with OMH, OASAS, DOH, Medicaid, and payor audit requirements. + Participate in licensing visits, accreditation surveys, and payor audits.… more
- Independent Health (Buffalo, NY)
- …will aid in training other team members, evaluating appeals, and share audit trends across the team. Expertise and proficiency demonstrated by long-standing, ... ability to train others, to identify coding patterns and share knowledge and audit tips across the team. The Clinical & Coding Specialist-Senior will support the… more
- Humana (Albany, NY)
- …onboarding and engagement in rehearsals. + Develop framework for supporting delegate audit readiness, coordinate with Delegation Compliance . + Support large ... certification + Six sigma certifications + Experience in an audit or compliance role for a Health...benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also… more
- Highmark Health (Buffalo, NY)
- …years in in a leadership role, preferably in a Quality, Accreditation, Audit , or Compliance discipline in a Healthcare or Healthcare related industry + 3 ... years overseeing quality, accreditation, audit , and/or compliance teams **Preferred** + None...control frameworks, and assessment methodologies, particularly as applied to healthcare (payer and provider) business processes + Knowledge of… more
- Mount Sinai Health System (New York, NY)
- …and Administration, Financial Lease Administration, Financial Due Diligence, Financial Audit /Reporting and Special Projects. Mainly responsible for the oversight of ... goals are achieved, this visible role oversees the lease management, tenancy audit and payment processes relating to all the Hospital's operating leases.… more
- Datavant (Albany, NY)
- …care management platforms, and third party integrations. + Balance innovation with compliance , audit defensibility, and clinical integrity across all product ... in health data exchange. Our vision is that every healthcare decision is powered by the right data, at...practices related to prospective risk capture and concurrent review. ** Compliance & Quality:** + Partner with Legal, Compliance… more
- Catholic Health Services (Rockville Centre, NY)
- …General Accounting Department, such as process redesign, system implementations, grant compliance initiatives, and audit readiness efforts. Collaborate with ... Long Island. Be a part of our team of healthcare heroes and discover why Catholic Health was named...external audit requests and manage responses to audit and compliance inquiries related to project… more
- Highmark Health (Albany, NY)
- …OVERVIEW:** Performs all related internal, concurrent, prospective and retrospective coding audit activities. Reviews medical records to determine data quality and ... with coding principles and guidelines. Promotes cooperation with CDMP and compliance programs to improve documentation which supports compliant coding. Interacts… more
- MVP Health Care (Schenectady, NY)
- Are you a strategic leader ready to shape the future of healthcare payment integrity? MVP Healthcare is seeking a visionary **Senior Director of Payment ... **Vendor Management & Performance Monitoring** + Manage external vendors supporting audit , analytics, and fraud detection. + Monitor vendor performance against SLAs… more
- Elderwood (Buffalo, NY)
- …experienced leader in revenue cycle management with a strong background in healthcare finance? Do you thrive in a high-accountability environment where precision, ... Specialist-and serve as a key liaison with internal and external audit entities. Your leadership will help ensure financial integrity, operational efficiency,… more