- Humana (Albany, NY)
- …complex data sets within large organizations + Experience working with Claims, Billing and Reconciliation or related healthcare data + Expertise in Microsoft Office ... are leading to a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at large. **Equal… more
- Weill Cornell Medical College (New York, NY)
- …in the practice's standard of operations policies regarding patient care and billing related activities. + Identifies areas of improvement for the front desk, ... + Working knowledge of third party payor reimbursement - Medicare, Medicaid , Managed Care and commercial insurance. **Licenses and Certifications** **Working… more
- Highmark Health (Albany, NY)
- …duties as specified. + Identify and report improper coordination of benefit billing practices through paid clams review. + Participate as pharmacy representative in ... formulary terminology + Pharmacy technicians must be familiar with multiple Medicaid drug benefit design offerings and rules/regulations across multiple states. They… more
- Healthfirst (NY)
- …environment with various opportunities** + **Knowledge of specialty pharmaceuticals and billing practices in the medical benefit** + **Knowledge of regulations of ... the Centers for Medicare and Medicaid Services including but not limited to National and Local** + **Coverage Determinations** + **PC Skills with Microsoft Word,… more
- Weill Cornell Medical College (New York, NY)
- …schedules. + Prepares charges and payments for submission to the billing office. + Identifies delinquent accounts for collection activities. Reviews status ... + Working knowledge of third party payor reimbursement - Medicare, Medicaid , Managed Care and commercial insurance. **Licenses and Certifications** **Working… more
- Cognizant (Albany, NY)
- …to referral, preauthorization, medical necessity, non-covered services, investigational/experimental and billing resulting in denials and/or delays in payment. . ... on the review of clinical documentation in accordance with Medicare, Medicaid , and third-party guidelines. . Effectively document and log claims/appeals information… more
- Catholic Health Services (Melville, NY)
- …and insurance information is on file for clinical submission and billing . DUTIES/RESPONSIBILITIES: + Determine whether authorization is required and utilize ... National and Local Coverage Decisions. + Maintain knowledge of Medicare, Medicaid and third-party payer regulations and hospital charging and collection policies.… more
- Stony Brook University (East Setauket, NY)
- …payment variances and denials. + Expert knowledge of Medicare and NY Medicaid Inpatient and Outpatient reimbursement methodologies. + Expert knowledge of third party ... healthcare claim drivers. + Expert knowledge of inpatient and outpatient billing requirements (UB-04, 837i). + Experience working with CPT/HCPCs and ICD-10… more
- Molina Healthcare (Yonkers, NY)
- …into actions/interventions to improve financial performance. * Advanced understanding of Medicaid and Medicare programs or other health care plans. * Advanced ... standard code systems (ICD-10CM, CPT, HCPCS, NDC, etc.) utilized in medical coding/ billing (UB04/1500 form). * Advanced understanding of key managed care concepts… more
- Lakeview Health Services (Geneva, NY)
- …+ Adhere to Medicaid , Office of Mental Health and Health Homes billing standards + Secure all health records and other protected information with the highest ... regard to confidentiality and + HIPPA laws and regulations + Provide each member of the caseload with a minimum of four health home core services per month, including but not limited to face to face, at home visits and telephonic contact + Engage families,… more