- Option Care Health (Albany, NY)
- …provider, there is no limit to the growth of your career.** Option Care Health , Inc. is the largest independent home and alternate site infusion services ... states. Through our clinical leadership, expertise and national scale, Option Care Health is re-imagining the infusion care experience for patients, customers and… more
- Catholic Health Services (Rockville Centre, NY)
- … system has over 16,000 employees, six acute care hospitals, three nursing homes, a home health service, hospice and a network of physician practices across the ... Overview Catholic Health is one of Long Island's finest ...assigned reports and provide accurate and timely information for review by the Director of Reimbursement or their designee.… more
- University of Rochester (Rochester, NY)
- …sterilization/hysterectomy consent form for compliance if missing from EMR. + Compliance + Review Medicare for MSP questions and validations. + Ensure compliance ... Type: Full time Scheduled Weekly Hours: 40 Department: 500183 Health Insurance Counseling Work Shift: UR - Day (United...incorrect effective dates for newborn and NICU cases. + Review each Maternity admission for insurance history by utilizing… more
- VNS Health (Manhattan, NY)
- …compliance with Medicare , Medicaid, and insurance guidelines and regulations regarding home health services. * Ensures timely discharge and missed visit to ... OverviewEnsures the overall delivery of home health services in accordance with...clinical team, under the guidance of an RN, to review clinical reports of providers for relevant patient data.… more
- Northwell Health (Staten Island, NY)
- …management and clinical pathways, variance analysis and trending, quality management/utilization review and home care/discharge planning, preferred. + Keeps ... in-patient liaison - planning, assessing, implementing and evaluating patient in collaboration with the health care team. + Serves as a resource to the health … more
- Arnot Health (Elmira, NY)
- …related to the management of patient care. The Case Manager will review all patients for utilization management and appropriate discharge planning. The Case ... and stay in accordance with Interqual. ** 2. Prepares Medicare /Non Medicare hospital notices of noncoverage (HINN)...In conjunction with the patient/family, other members of the health care team, the payer, and available resources, formulates… more
- Excellus BlueCross BlueShield (Buffalo, NY)
- …professional and community standards and issue. + Ensures that other Behavioral Health medical directors reviewing pediatric cases review those cases in ... and support for the development and implementation of the Children's Behavioral Health (BH) Carve-In program. The Medical Director for BH Children's Services has… more
- University of Rochester (Rochester, NY)
- …audits, and third-party payer audits. - Coordinate responses and resolution to Medicaid and Medicare credit balances- - - Review all accounts on the Medicaid and ... resolution and adjudication, including refund of credits - - Review and advise supervisor or manager on trends of...reports:- - - 2nd insurance level report - - Medicare and Medicaid credit balance report - - Over… more
- Lakeview Health Services (Geneva, NY)
- …+ Complete duties in accordance with the guidance issued by the Office of Mental Health specific to C&Y Health Home Non-Medicaid Care Management. Experience, ... + Employee Assistance Program (EAP) + Tuition Assistance Agency Overview Lakeview Health Services is a premier partner throughout the Finger Lakes region, providing… more
- CenterLight Health System (NY)
- …execution of enterprise-wide (CenterLight and its associated entities including C2Q Health Solutions, and Team Care Medical) billing and revenue maximization ... overseeing member and provider outreach for Dual conversion, ESRD, and Nursing Home entitlements. + Perform membership and claims analytics, including IBNR, MMR and… more