- CCSI INC (Norwich, NY)
- …+ Establish and operationalize internal evaluation and auditing processes, including billing audits and quality documentation audits that are routine and effectively ... with training and resolution of issues relating to protection and security of Medicaid Confidential Data. + Ensure submission, after full review, of agency's Annual… more
- 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
- 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
- Molina Healthcare (Rochester, NY)
- …with the standards and requirements established by the Centers for Medicare and Medicaid Services (CMS). **Essential Job Duties** * Enters denials and requests for ... Qualifications** * Customer/provider experience in a managed care organization ( Medicaid , Medicare, Marketplace and/or other government-sponsored program), or medical… more
- Humana (Albany, NY)
- …investigations of reported, alleged or suspected fraud involving Florida's Medicaid Program. The Fraud and Waste Professional 2 coordinates investigation ... Conducts on-site audits of provider records ensuring appropriateness of billing practices. Prepares complex investigative and audit reports. Understands department,… more
- RiseBoro Homecare Inc. (Brooklyn, NY)
- …requires a strong understanding of homecare regulations related to Medicare, Medicaid , and other insurance programs. The Intake Specialist will collaborate closely ... Home Health Aide Program (CHHA) and Managed Long-Term Care (MLTC), Medicaid , insurance verification, Maximus procedures, and MLTC enrollment. . Collaborate and… more
- Northwell Health (Melville, NY)
- …Job Responsibility + Understanding of various insurance carriers, including Medicaid , Medicare, HMOs, Workers Compensation, No Fault, contracted and non-contracted ... assure accurate and timely payment of accounts. + Verifies completeness and accuracy of billing data and revises any errors. + Review and respond to third party,… 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 ... review findings. + Must be able to articulate findings to investigators, Medicaid plan leadership, law enforcement, legal counsel, providers, state regulators, etc.… more
- BronxCare Health System (Bronx, NY)
- …and collects co payments, self-payments. Generates receipts, verifies registration billing information of patients, and obtains managed care insurance referrals. ... urgent. Issue Metro-card to all eligible clients. Complete managed care and Medicaid transportation logs correctly. - If applicable, ensures that consult reports are… more