- Centene Corporation (Latham, NY)
- …sales/marketing experience, preferably with government products. required Health insurance or managed care experience preferred Specific language skills may be ... required by some plans. Driver's License may be required by some plans. Specific language skills may be required by some plans Life and Health License (can be obtained within 90 days of employment) - If required by the Business Unit/Department **For Medicare… more
- WMCHealth (Hawthorne, NY)
- …to Revenue Cycle leadership as necessary + Monitors contract compliance and escalates to Managed Care staff as needed + Provides denial trends to Billing ... Functional Leader for operational improvement + Works with Local System Coding leaders to determine appropriate changes for DRGs, CPT, and ICD PX related denials + Displays commitment to treating both internal and external constituents as clients and… more
- Interstate Waste Services, Inc. (Sloatsburg, NY)
- …actions. + Participateand lead Incident Review Team meetings as needed. + Assistin managed care of injuries. + **Risk Mitigation** + Identify potential hazards ... and implement proactive measures to reduce risk. + Oversee the use of personal protective equipment (PPE) and ensure proper usage. + Collaborate with operations to ensure safe routing, loading, and disposal practices. + **Regulatory Reporting & Documentation**… more
- The Institute for Family Health (New Paltz, NY)
- …SKILLS: + Thorough understanding of FQHC, Article 28, Article 31, dental CMS, managed care , sliding fee, and commercial payer billing guidelines and regulations. ... + Understanding of the implications of facility/group agreements with health plans and the supplemental payment process + Ability to export, analyze, and format data which may include the development of graphs. + Ability to resolve staffing issues with tact… more
- Regeneron Pharmaceuticals (Sleepy Hollow, NY)
- …(eg, NICE) is helpful. Customer-facing experience at country level is required. US managed care experience is a strong advantage. Does this sound like ... you? Apply now to take your first step towards living the Regeneron Way! We have an inclusive and diverse culture that provides comprehensive benefits, which often include (depending on location) health and wellness programs, fitness centers, equity awards,… more
- KPH Healthcare Services, Inc. (East Syracuse, NY)
- …: Incidental travel required **Scope of Responsibilities:** Oversight responsibility for the managed care department of the company. Responsible for training, ... development and conducting performance reviews of subordinate staff, estimating personnel needs, assigning work, meeting completion dates, interpreting and ensuring consistent application of organizational policies. **Job Summary** : Responsible for analyzing… more
- Molina Healthcare (Syracuse, NY)
- …adjudication, QNXT system navigation, and strong analytical acumen. Experience in Medicaid managed care is required, and a background in payment integrity-either ... at a health plan or vendor-is strongly preferred. **Knowledge/Skills/Abilities** + Review Medicaid COB claims for correct secondary pricing logic and compliance with configuration and regulatory rules. + Analyze claim outcomes and identify trends or… more
- Molina Healthcare (Yonkers, NY)
- …for both internal staff and vendor oversight. + Experience working within a Managed Care Organization (MCO) or health plan environment. + Proven ability ... to manage complex vendor relationships and recovery strategies (eg, first-pass and second-pass vendor models). + Strong understanding of federal and state regulations related to subrogation, including HIPAA, Medicaid TPL requirements, and CMS guidelines. +… more
- Albany Medical Center (Albany, NY)
- …To assist in the day-to-day function of the Patient Receivable Control & Managed Care Reporting Department. + Specific Responsibilities + Assist the ... Administrative Support Associates with the daily cash processing, maintaining the cash files, and other related receivable control tasks. + Prepare journal entries associated with the cash flow of patient reimbursements, accommodation transfers, and other… more
- Access: Supports For Living (Middletown, NY)
- …Minimum 3 years' commensurate experience required. + Prior experience with medicar/Medicare managed care billing + Behavioral Health Insurance billing knowledge ... + Excellent problem solving skills. + Excellent computer skills (Proficient in Excel). + Excellent organization skills. + Excellent communication skills. + Can work both independently and in a team environment. Education & Experience: + High School graduate. +… more