- Northwell Health (New York, NY)
- …care setting (preferred) + Claims adjudication experience + Knowledge of MLTC/ Medicaid / Medicaid benefit + Knowledge of Member (Subscriber) enrollment & billing ... + Knowledge of Utilization Authorizations + Knowledge of Provider Contracting + Knowledge of CPTs, ICD 9/ICD 10, HCPC, DRG, Revenue, RBRVS + Proficiency in MS Excel, Word, PowerPoint, and experience using a claims processing system or comparable database… more
- The Arc Erie County NY (Williamsville, NY)
- …disabilities and their families. + Regulatory Knowledge - Understands OPWDD, Medicaid , and educational compliance requirements. + Leadership - Guides and motivates ... are compliant with federal, state, and local regulations, including OPWDD and Medicaid standards. + Maintain accurate, audit-ready records of intake and admissions… more
- Callen-Lorde Community Health Center (New York, NY)
- …timely third-party revenue collection, including insurance verification and Medicaid authorizations. + Overseeing hiring, training, scheduling, and performance ... to lead, train, and mentor teams on complex processes. + Experience with Medicaid , Medicare, ACA plans, and private insurance. + Proficiency with EPIC EHR and… more
- New York State Civil Service (NY)
- …and process level of care eligibility determinations (lced's) * Confirm Medicaid status/enrollment; communicate with the revenue support field office (rsfo) to ... eligibility for full and unconditional participation in the Medicare and Medicaid programs. Continued employment will depend on maintaining eligibility. * If… more
- Humana (Albany, NY)
- …revenue cycle management (related to billing, coding, collections for Medicare and Medicaid claims) + Experience with Auditing and monitoring of healthcare records + ... are leading to a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at large. **Equal… more
- Molina Healthcare (Syracuse, NY)
- …evaluate, and submit encounter deletions for Medicare Advantage, ACA, and Medicaid lines of business. This role has decision-making accountability for ensuring ... or above. + Extensive understanding of Medicare Advantage, ACA and Medicaid risk adjustment processes, including encounter data submission and deletion requirements… more
- New York State Civil Service (Bronx, NY)
- …eligible and maintain eligibility for full and unconditional participation in the Medicaid and Medicare program. Failure to maintain licensure, certification and ... Medicaid /Medicare eligibility will result in the termination of employment. Additional Comments Salary:$45.51OASAS ATC's are Tobacco-Free facilities.Background… more
- New York State Civil Service (New York, NY)
- …Comments: These positions are eligible for a Downstate Adjustment of $4,000. Medicaid /Medicare Requirements: In order to be eligible for appointment and to ... as an excluded individual or entity on any of the Federal and/or State Medicaid and Medicare exclusion lists (or excluded from any other Federal or Federally… more
- Molina Healthcare (Syracuse, NY)
- …or equivalent combination of relevant education and experience + Medicare and/or Medicaid Managed Care experience + Quantitative aptitude + Strong leadership in a ... experts, and external resources. **PREFERRED QUALIFICATIONS:** + Integrated products ( Medicaid -Medicare) experience + Experience in regulatory regulations and monitoring… more
- Robert Half Accountemps (Rochester, NY)
- …and transactions, maintaining detailed records of all payments. * Perform Medicaid billing tasks, ensuring compliance with relevant regulations. * Utilize accounting ... knowledge of accounts receivable functions and processes. * Experience with Medicaid billing and related compliance requirements. * Familiarity with cash handling… more