- Bausch Health (Buffalo, NY)
- …accounts Demonstrate expertise across the product portfolio, therapeutic areas, and managed care Effectively manage territory by routinely analyzing data ... to target high prescribing HCPs Develop and deliver effective sales presentations on the organizations products to target HCPs Meet or exceed established call average and sales performance expectations Demonstrate market and industry knowledge relative to… more
- Molina Healthcare (Syracuse, NY)
- …**X** **PE** **R** **I** **E** **N** **C** **E:** + Min. 2 years operational managed care experience (call center, appeals or claims environment). + Health ... claims processing background, including coordination of benefits, subrogation, and eligibility criteria. + Familiarity with Medicaid and Medicare claims denials and appeals processing, and knowledge of regulatory guidelines for appeals and denials. + Strong… more
- Molina Healthcare (Yonkers, NY)
- …EXPERIENCE** : * 5-7 years of Program and/or Project management experience. * Managed Care experience. * Experience working in a cross functional highly ... matrixed organization. **PREFERRED LICENSE, CERTIFICATION, ASSOCIATION** : * PMP, Six Sigma Green Belt, Six Sigma Black Belt Certification and/or comparable coursework desired. To all current Molina employees: If you are interested in applying for this… more
- New York State Civil Service (Albany, NY)
- …this position will coordinate efforts with other OMH divisions, such as licensing and managed care , to interpret data, create and implement work plans, and ... assist on specific projects as assigned. Specific duties to be performed may include, but are not limited to, the following: Provide guidance to children's mental health providers on services and programs, responding to provider inquiries and requests for… more
- Access: Supports For Living (Middletown, NY)
- …portals. + Maintain a working knowledge of OMH, OASAS, Medicare, Medicaid, Medicaid Managed Care and other payers' billing regulations for all programs. + ... Understand and remain updated with current coding and billing regulations and compliance requirements + Oversight of self-pay processing and assist with monitoring on participant outstanding balances + Provide credentialing management support working with… more
- Molina Healthcare (Rochester, NY)
- …in provider claims investigation/research/resolution/reimbursement methodology analysis within a managed care organization, or equivalent combination of ... relevant education and experience. * Research and data analysis skills. * Organizational skills and attention to detail. *Time-management skills, and ability to manage simultaneous projects and tasks to meet internal deadlines. * Customer service experience. *… more
- Cognizant (Albany, NY)
- …Medicare eligibility, enrollment operations, health plan administration, or regulatory policy in managed care , state programs, or integrated provider systems + ... Proven experience operating in regulated healthcare environments with direct responsibility for eligibility strategy, policy interpretation, and program execution + Minimum of five (5) years of leadership experience managing large or multi-state eligibility… more
- Outreach Development Corporation (Richmond Hill, NY)
- …compliance with healthcare regulations, and payer requirements (eg, Medicare, Medicaid, Managed Care Organizations, and Commercial/Private insurers). + Implement ... and maintain billing procedures and best practices to optimize revenue collection. + Managing the collection process, including follow-up on outstanding claims and patient balances, and resolution of billing/denial issues. + Analyzing billing and collections… more
- Insight Global (Syracuse, NY)
- …required, including regulatory compliance requirements. Extensive knowledge of Medicare, Medicaid, Managed Care is required. Strong analytical and computer ... skills are required along with the ability to interpret data to identify trends or areas for improvement, and present information in a succinct, actionable manner. Requires strong written and verbal communication skills as well as ability to interact and… more
- Cardinal Health (Albany, NY)
- …+ Oversee the ongoing training needs of the customer, the ISF, and the Managed Care Support Team including conducting regular webinar trainings. + Analyze ... Central Pay payment data and provide succinct recap showing trends and abnormalities, including identifying potential credit risks requiring immediate attention. + Communicate updates within region to key internal stakeholders within sales, operations, and… more