- Erie 2-Chautauqua-Cattaraugus BOCES (Williamsville, NY)
- …agency, the Office for People With Developmental Disabilities OPWDD, Medicaid , Medicare, insurance companies, municipalities, Department of Health, school districts, ... Professions, the Office for People With Developmental Disabilities (OPWDD), Medicaid , Medicare, insurance companies, municipalities, Department of Health, school… more
- CVS Health (Albany, NY)
- …state, federal and company requirements are met and recognize any concerning billing patterns or trends. Activities include: - Conduct a comprehensive medical record ... review to ensure billing is consistent with medical record. - Provide detailed...- Must be able to articulate findings to investigators, Medicaid plan leadership, law enforcement, legal counsel, providers, state… more
- Northern Rivers Family Services (Albany, NY)
- …You will maintain an accurate, reliable credentialing status database for internal and external billing company use. You may also perform a variety of billing , ... for which provide billable services or are required to register with Medicaid /Medicare based on their credential, department and position. + Work with organizational… more
- WellLife Network (Coram, NY)
- …will complete all initial workflow documentation. + Responsible for completing all billing activities for members enrolled within the month of service. + Utilize ... ensure accurate caseload status (including enrollments and screen outs). + Monitor Medicaid /MCO status for all outreach clients twice monthly; complete all required… more
- Ellis Medicine (Schenectady, NY)
- …setting preferred. + Must have knowledge of medical records, medical terminology and billing requirements, CPT, HCPCS and ICD-9 coding and be able to apply such ... information on programs to assist patient and family financial issues (ie Medicaid Program, Uncompensated Care). + Facilitates in gathering accurate patient … more
- Stony Brook University (East Setauket, NY)
- …and validate business processes and business systems configuration, including: Patient Billing , Claims Scrubber, Contract Management and Work Listing Software. + ... Interpret billing , coding and payment regulations, third party contracts. **Qualifications:**... requirements (UB-04) and CMS Medicare and New York Medicaid reimbursement methodologies. + Knowledge of third party payer… more
- MVP Health Care (Schenectady, NY)
- …teams. + Leverage predictive analytics and rules engines to identify suspicious billing patterns. + Ensure timely investigation, documentation, and resolution of FWA ... Compliance & Industry Engagement** + Monitor and ensure compliance with CMS, Medicaid , ACA, and state-specific regulations. + Lead responses to regulatory audits and… more
- New York State Civil Service (Staten Island, NY)
- …services, information and referral services and residential services. * Oversee the billing of treatment services of the program to the insurance companies including ... and maintain eligibility for full and unconditional participation in the Medicaid /Medicare programs. Failure to maintain licensure, certification and Medicaid… more
- New York State Civil Service (Jamaica, NY)
- …cash flow projections, capital outlay and fixed assets schedules, and Medicaid & Medicare reimbursement activities for the facility.* Develops, implements, reviews, ... This challenging opportunity requires competence in: i) preparing Medicare and Medicaid cost reports for healthcare facilities; ii) utilizing the Statewide Financial… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …coding, Medicare Advantage and Commercial Hierarchical Condition Category (HCC) coding, and Medicaid Clinical Risk Groups (CRGs) to ensure compliance. * Assist in ... CPT, HCPC) * Familiarity and understanding of CMS HCC Risk Adjustment coding, Medicaid CRG coding, and data validation requirements, preferred. * Strong written and… more