- Molina Healthcare (Buffalo, NY)
- …different standard code systems (ICD-10CM, CPT, HCPCS, NDC, etc.) utilized in medical coding /billing (UB04/1500 form) + Demonstrated understanding of key managed ... of provider reimbursement changes + Provide data driven analytics to Finance, Claims , Medical Management, Network, and other departments to enable critical… more
- KPH Healthcare Services, Inc. (Syracuse, NY)
- …Summary:** Responsible for developing, improving and continuing the process billing of medical claims for specialty pharmacy facilities. Needs to communicate ... assigned tasks. Establish, manage, and communicate the process of billing medical claims for specialty facilities. **Responsibilities** **Job Duties:** +… more
- Ellis Medicine (Schenectady, NY)
- …weekly chart audits for practice providers to optimize accurate documentation and coding . Additionally, all Medical Coder will participate in regularly scheduled ... insurance coding and billing experience required. + Working knowledge of healthcare revenue cycle functions, including coding and billing guidelines and… more
- Molina Healthcare (Syracuse, NY)
- …to health care fraud, waste, and abuse. Duties include performing accurate and reliable medical review audits that may also include coding and billing reviews. ... with various internal customers (eg, Provider Services, Contracting and Credentialing, Healthcare Services, Member Services, Claims ) to gather documentation… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …documents including, but not limited to provider contracts, group benefit structures, Corporate Medical Policies, the AMA CPT Coding Guidelines, HCPCS coding ... and concise manner. + Analyzes proactive detection reports and claims data to identify red flags/aberrant billing patterns. +...within one year of hire date. + Knowledge of medical record coding conventions (eg CPT, DRG,… more
- Robert Half Technology (New York, NY)
- Description We are looking for a skilled Healthcare Project Manager to lead critical initiatives within the payment integrity domain. This role requires a strategic ... thinker with a strong background in healthcare operations and project management, capable of driving cross-functional...At least 2 years of experience with validation processes, claims adjudication, or hospital bill audits. * Strong knowledge… more
- Mount Sinai Health System (New York, NY)
- …or a related field. + Additional certifications (eg, CPC, CCS, or related healthcare coding certifications) are a plus. **Experience Requirements** + Minimum 3-5 ... management systems, modeling software, and financial reporting tools. + Familiarity with healthcare coding standards (eg, CPT, ICD-10, HCPCS) and reimbursement… more
- Molina Healthcare (New York, NY)
- …better health, more affordably. Performs research, financial modeling, and analysis of complex healthcare claims data ( medical , pharmacy and ancillary) to ... Education** Master's Degree **Preferred Experience** + Preferred experience in healthcare medical economics and/or strong financial analytics background… more
- New York State Civil Service (Pearl River, NY)
- …Experience with statistical sampling and/or advanced statistical training.* Knowledge of the healthcare industry and medical coding concepts (CPT, ICD-9 ... Attorney General, Office of the Title Forensic Auditor: Investigate Complex Healthcare Fraud, 6405 Occupational Category Financial, Accounting, Auditing Salary Grade… more
- Mount Sinai Health System (New York, NY)
- …plus 3 years of relevant experience + Certified coder required + Experience in medical billing or health claims , with experience in EPIC & IDX billing ... these processes to ensure accurate and timely payment of claims and collection, and in analysis and problem resolution....in IDX using approved methodologies. 8. May perform specialty coding for services and medical office visits… more