- Humana (Albany, NY)
- **Become a part of our caring community and help us put health first** In this role, you will conduct quality reviews of coding processes within the Claims Cost ... initiatives and develop educational materials. This is a full-time, remote/work-from- home position. **Description** The Inpatient Medical Coding Auditor extracts… more
- Bassett Healthcare (Cooperstown, NY)
- …reviews in coordination with managers using information and assumptions. . Oversee network home office reporting system for Medicare Cost reporting. . Identify ... you looking to make a difference by improving the health of our patients? Here you will find an...unique funding levels in Medicaid and Medicare based on rural provider status. . … more
- WTW (New York, NY)
- …prior in-house experience a plus but not required. + Employee benefits, Medicare , health insurance, financial, privacy and/or regulatory background preferred. + ... candidate may also have knowledge and experience in the employee benefits, health insurance, or financial industries. More specifically, knowledge of ERISA, … more
- New York State Civil Service (Goshen, NY)
- …a member of a treatment team.PRIMARY DUTIES AND RESPONSIBILITIES:* Monitors individual's medical/ health needs and services.* Visits each assigned home weekly ... your caseload, completes review of medical section ISP, medication audit (each home )* Keeps up to date regarding changes to medical section on ISP* Responsible… more
- New York State Civil Service (NY)
- …Monitors individual's medical/ health needs and services. * Visits each assigned home weekly (minimally) to provide nursing oversight and complete review of ... Disabilities, Office for Title Registered Nurse 1 Occupational Category Health Care, Human/Social Services Salary Grade 18 Bargaining Unit...review of medical section ISP, medication audit (each home ). * Keeps up to date regarding changes to… more
- Healthfirst (NY)
- …+ Electronic patient health information (PHI) database experience + Knowledge of health insurance, Medicaid, Medicare and MLTCP + Experience working with a ... **Duties and Responsibilities:** + Conduct home assessments for prospective members and re-assessments of current members using the Uniform Assessment System (UAS);… more
- Excellus BlueCross BlueShield (Buffalo, NY)
- …for the following programs, including but not limited to: * Prospective medical record review of health plan providers * Retrospective medical record review ... were correctly reimbursed and documented. Reports findings of the data validation review . Prepares and submits adjustments to the appropriate processing / adjustment… more
- New York State Civil Service (Hawthorne, NY)
- …your caseload, completes review of medical section ISP, medication audit (each home )* Keeps up to date regarding changes to medical section on ISP.* Responsible ... With Developmental Disabilities, Office for Title Registered Nurse 1 Occupational Category Health Care, Human/Social Services Salary Grade 18 Bargaining Unit PS&T -… more
- Evolent (Albany, NY)
- **Your Future Evolves Here** Evolent partners with health plans and providers to achieve better outcomes for people with most complex and costly health ... care, we seek to connect the pieces of fragmented health care system and ensure people get the same...+ **Computer proficiency** and ability to navigate electronic medical review platforms. + No current exclusions, sanctions, or disciplinary… more
- New York State Civil Service (Brooklyn, NY)
- …Disabilities, Office for Title Registered Nurse 2 (Community) Occupational Category Health Care, Human/Social Services Salary Grade 20 Bargaining Unit PS&T - ... LPNs who will supervise the AMAP staff in providing Direct Support Assistants health care per the nurse Act Exemption.*Ensure all medical follow-up is done… more
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