- City of New York (New York, NY)
- …from the Social Security Administration for SN/SSI clients and SSP refunds and Medicaid Spend Down program payments. DARB is responsible for the collections, refunds ... of these payments being extremely time sensitive and trigger Medicaid coverage for customers. The Office of Fiscal Operations...as IREA Claims & Collections and the Bureau of Fraud and Investigation, submit payments received from customers for… more
- City of New York (New York, NY)
- …in reducing fraud . Ensure staff perform quality assurance on EMEDNY, Medicaid Data Warehouse (MDW), Enterprise Data Warehouse (EDW) MA queries, and WMS look-ups. ... potential errors by reviewing records of Cash Assistance and Medicaid Assistance Program (MAP) cases and analyzing their contents...III to function as the Unit Supervisor in the Medicaid Data Analysis Unit who will: Supervise and guide… more
- CVS Health (Albany, NY)
- …day. **Position Summary** We are seeking an experienced Senior Healthcare Fraud Investigator to join our Dental/Pharmacy/Broker Investigative Team within Aetna's ... will manage complex investigations into suspected and known acts of healthcare fraud , waste and abuse (FWA). **Key Responsibilities** + Conduct high level, complex… more
- City of New York (New York, NY)
- Job Description APPLICANTS MUST BE PERMANENT IN THE FRAUD INVESTIGATOR CIVIL SERVICE TITLE The DSS Accountability Office (DSS-AO) is responsible for protecting the ... It is also responsible for evaluating and assessing the resources of Medicaid Nursing Home residents through computer bank matches, assessing the income and… more
- City of New York (New York, NY)
- …data analytics, data reporting, database hosting and systems used for fraud investigation, revenue collection activities and tracking. Ensure business continuity for ... program eligibility. Additionally, designing and operating analytics processes to identify Medicaid savings, both within DSS and State Department of Health (SDOH),… more
- City of New York (New York, NY)
- …from the Social Security Administration for SN/SSI clients and SSP refunds and Medicaid Spend Down program payments. DARB is responsible for the collections, refunds ... of these payments being extremely time sensitive and trigger Medicaid coverage for customers. The Finance Office is requesting...areas such as IREA Claims and Collections, Bureau of Fraud Investigation and the Office of Liens and Trusts.… more
- CVS Health (Albany, NY)
- …the ICD codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) for the purpose of risk adjustment processes are appropriate, accurate, ... education opportunities for peers. + Extensive knowledge of medical documentation, fraud , abuse and penalties for documentation and coding violations based on… more
- City of New York (New York, NY)
- …makes programmatic and procedural recommendations to HRA programs to deter participant fraud . Office of Administrative Support (OAS) is the central repository for ... - Record and process manual and electronic checks received from Bureau of Fraud Investigation, Claims and Collections, Liens and Recovery and checks delivered to the… more
- Otsuka America Pharmaceutical Inc. (Albany, NY)
- …and coding in rare disease + Strong knowledge of Centers for Medicare & Medicaid Services (CMS) policies and processes, especially Medicare Part D + Experience in ... contacting Accommodation Request ([email protected]) . **Statement Regarding Job Recruiting Fraud Scams** At Otsuka we take security and protection of… more
- City of New York (New York, NY)
- …DSS AO, the Office of Liens & Trusts (OLT) is responsible for protecting against fraud and recovering Cash Assistance and Medicaid pursuant to SSL 104, 104-b, ... a disabled person with excess resources to shelter their assets and qualify for Medicaid . SNT is recruiting for one (1) Executive Agency Counsel M-II to function as… more