- New York State Civil Service (New York, NY)
- …Specialist 2; ANDEligibility for full and unconditional participation in the Medicaid and Medicare programs.OROpen Competitive:Possession of a license to practice ... AND Eligibility for full and unconditional participation in the Medicaid and Medicare programs. OR Provisional Opportunity - Possession...or entity on any of the Federal and/or State Medicaid and Medicare exclusion lists (or excluded from any… more
- Humana (Albany, NY)
- …Business Intelligence Engineer position will be supporting BI work for our Medicaid organizations. The Humana CPSS Data & Analytics - BI (Business Intelligence) ... Engineer position will be supporting BI work for our Medicaid organizations. This individual will be responsible for: +...tools such as SSRS or SSIS + Knowledge of Medicaid or Medicare services + Advanced data analytics skills… more
- Teresian House (Albany, NY)
- …billing of all services rendered to residents in compliance with NYS Medicaid , Medicare, Mafae Care Organizations (MCO's) and private insurance. + Preparing and ... + Preparing and submitting timely billing for Medicare, MCO's, Medicaid and private insurers using electronic and payer formats....up to date knowledge of Medicare, MCO and NYS Medicaid regulations and billing practices. + Working with other… more
- Molina Healthcare (Yonkers, NY)
- …Assists and executes tasks and projects to ensure Centers for Medicare & Medicaid Services (CMS) and State regulatory requirements are met for Pre-pay Edits, ... Care Organization (MCO) or health plan setting, including experience in Medicaid and/or Medicare, or equivalent combination of relevant education and experience… more
- Humana (Albany, NY)
- …ensure successful submission and reconciliation of encounter submissions to Medicaid /Medicare. Ensures encounter submissions meet or exceed all compliance standards ... and develops tools to enhance the encounter acceptance rate by Medicaid /Medicare. Looking for long-term improvements of encounter submission processes. Begins to… more
- City of New York (New York, NY)
- …program eligibility. Additionally, designing and operating analytics processes to identify Medicaid savings, both within DSS and State Department of Health (SDOH), ... directly saving hundreds of millions of dollars in annual Medicaid spending. This work includes identifying Medicaid ...annual Medicaid spending. This work includes identifying Medicaid clients who should apply for Medicare, identifying … more
- City of New York (New York, NY)
- …process applications including screening, intake, and assessment and monitoring of Medicaid eligibility and all related community alternative health care services, ... direction of the personnel engaged in processing applications, monitoring Medicaid eligibility and conducting eligibility assessments for community alternative… more
- City of New York (New York, NY)
- …standards. Within the Office of Quality Assurance & Fiscal Integrity, the Medicaid Quality Control Unit (MAQC) conducts complex internal audits and quality control ... need for corrective action plans and/or training. MAQC also ensures the Medicaid programs' continuous adherence to state and federal regulations. State and Federal… more
- Helio Health Inc. (Utica, NY)
- …produce cash receipts. + Review other methods of payment such as third-party and Medicaid . + Assist patients with Medicaid applications, obtain patient ID, rent ... as needed. + Works with patients, third party payers, Medicaid , State and Federal agencies to collect payment, address...claim denials. + Prepares weekly and monthly reports of Medicaid billing for the Manager of Revenue Cycle Management… more
- Outreach Development Corporation (Richmond Hill, NY)
- …and pending bills. In this role ongoing attention to regulatory changes in Medicaid and other public assistance programs as well as in establishing and maintaining ... calls, emails or both of any changes in client's Medicaid /Child HealthPlus or insurance benefit status as well as...staff/supervisors. + Stay current on regulatory changes related to Medicaid , Child Health Plus and other insurances that may… more