- Bassett Healthcare (Herkimer, NY)
- …thing about this role Are you looking to make a difference by improving the health of our patients? Here you will find an innovative culture that is patient-focused ... the population we serve, and our communities, achieve optimum health and enjoy the best quality of life possible....primary purpose of the Care Coordinator, Registered Nurse Nursing Home is to assist the Director of Nursing in… 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
- Excellus BlueCross BlueShield (Rochester, 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
- Humana (Albany, NY)
- **Become a part of our caring community and help us put health first** The Senior Inpatient Medical Coding Professional extracts clinical information from a variety ... and approaches to assignments. + Reviewing staff monthly QA review variances + Daily inventory monitoring and assignment of...skills to make an impact** **WORK STYLE:** Remote/work at home . While this is a remote position, occasional travel… more
- FlexStaff (Bronx, NY)
- …Supervisor (NPS) for our client, a non-profit healthcare organization providing home and community-based healthcare and services for the elderly. PURPOSE: The ... from hospital/ED within 5 days, reconcile medications, and coordinate follow-up. + Review medical history every 6 months, formulate diagnoses, and ensure accurate… more
- University of Rochester (Rochester, NY)
- …working claim activity in EPIC + Works in assigned EPIC follow up workqueue(s). + Review reason for claim denial - reason code or denial codes in EPIC. + View ... Payer Website link (EPIC Insurance Coverage tab), review payer website, or contact payer representative as to...audits + Coordinate responses and resolution to Medicaid and Medicare credit balances. + Request insurance adjustments or retractions.… more
- Humana (Albany, NY)
- **Become a part of our caring community and help us put health first** Call Quality Professionals provide information that will assist in the feedback and the formal ... your skills to make an impact** **Required Qualifications** **Active Health insurance license or the ability to obtain within...protection. Please be aware that applicants selected for leader review may be asked to provide their social security… 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...sources, including the American Medical Association (AMA), Centers for Medicare & Medicaid Services (CMS), Food and Drug Administration… more
- New York State Civil Service (Albany, NY)
- …Office for Title Mental Hygiene Program Evaluation Specialist 3 Occupational Category Health Care, Human/Social Services Salary Grade 23 Bargaining Unit PS&T - ... calls, email, commissioner's correspondence, and information line inquires - In the review and processing of Article 16 Clinic's Certificate of Need (CON)… 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