- KPH Healthcare Services, Inc. (Rochester, NY)
- …account reconciliation + Account adjustments, bad debt processing + Third party, Medicare, Managed Care , and private billing, claim corrections and follow-up + ... listen attentively to their needs and respond appropriately + Safety: Must take care of equipment and employ good safety habits + Leadership: Must gain acceptance… more
- Educational Alliance, Inc. (New York, NY)
- …clinical charts, engaging in pre-audits of charts to ensure compliance with OASAS, managed care , and CARF standards. + Send weekly, monthly, and quarterly ... Familiar with Regulatory Agency/OASAS Regulations regarding the operation and practices of patient care . + An understanding of group dynamics is essential. + Must be… more
- BronxCare Health System (Bronx, NY)
- …years experience with verification/eligibility of insurance Familiar with Medicaid, Medicare and Managed Care guidelines Knowledge of medical terminology Must be ... service; or at bedside, to verify demographic, Insurance and primary care physician information. Process to include insurance verification and eligibility,… more
- Humana (Albany, NY)
- …of experience consulting/supporting large scale, strategic initiatives + Previous healthcare or managed care experience, preferably in the Medicaid space + ... for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a… more
- Highmark Health (Albany, NY)
- …auditing, investigations, regulatory accreditation, process improvement, project management and/or managed care operations **Knowledge, Skills and Abilities** + ... and policies and regulatory bodies; performing and providing oversight of the care management delegation functions of multiple vendors through review of annual… more
- Humana (Albany, NY)
- …in a management field + Prior healthcare industry experience, preferably in the managed care or provider sector **Reporting Relationships** The role reports to ... for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a… more
- Catholic Health (Buffalo, NY)
- …The Manager Government Reimbursement reports to the Director Government Reimbursement and Managed Care . The Manager is responsible for the coordination, ... EXPERIENCE + A minimum of five (5) years progressive experience in health care finance + Extensive understanding of Medicare and Medicaid regulations, cost reports,… more
- Centene Corporation (New York, NY)
- …equivalent experience. 4+ years of experience in nursing, training, or auditing in a managed care healthcare setting. Experience in a lead or supervisory role ... Auditor & Trainer will conduct audits of inpatient coding processes for Fidelis Care and assist in development of training and audit tools. The Senior Clinical… more
- Ellis Medicine (Schenectady, NY)
- …Soarian systems and Allscripts electronic health records preferred. + Must understand managed care concepts and healthcare regulations. + Excellent communication ... to assist patient and family financial issues (ie Medicaid Program, Uncompensated Care ). + Facilitates in gathering accurate patient billing information. + Performs… more
- Humana (Albany, NY)
- …Medicare and/or Medicaid experience + 3 or more years clinical experience in managed care + Ability to manage end-to-end-processes + Understand Humana's business ... for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a… more