- Mount Sinai Health System (New York, NY)
- …implementation and contract compliance related to Facility Contracts for all Commercial, Medicare Advantage and Medicaid Managed Care Plans. The team serves as ... Health System. MSHP seeks a Senior Contract Compliance (Professional Billing ) Analyst who will primarily be responsible for tracking,...Sinai Health System is one of the largest academic medical systems in the New York metro area, with… more
- Fresenius Medical Center (Vestal, NY)
- …options: + Educates on the availability of alternative insurance options (ie, Medicare , Medicaid, Medicare Supplement, State Renal programs and COBRA). + ... + Discusses insurance options when insurance contracts are terminated. Responsibilities involving Medicare and Medicaid include but are not limited to: + Determining… more
- University of Rochester (Brighton, NY)
- …and New York State Medicaid). Stays abreast of Medicare and Medicaid billing requirements. + Collaborates closely with the Medical Center's Office of ... + Self-Referral Law, the False Claims Act, Civil Monetary Penalties, and + Medicare and Medicaid billing regulations (including CMS, Medicare Advantage… more
- FlexStaff (Chappaqua, NY)
- …feedback, and performance management. Qualifications: - Minimum of 3-5 years of experience in medical insurance billing and claims management, with a focus on ... **Req Number** 168166 Claims Management Specialist Are you a seasoned medical insurance professional with a passion for leadership and operational excellence?… more
- Mount Sinai Health System (New York, NY)
- …plans for resolving billing disputes. + Keeps abreast of changes in Medicare and Medicaid regulations that impacts Practice and Billing Office operations. + ... in accordance with established fee schedules and ensures compliance with Medicare and other insurance carrier guidelines. **Qualifications** + Associate?s degree in… more
- FlexStaff (New York, NY)
- … Medical Biller with extensive experience and strong technical knowledge of medical billing and insurance reimbursement processes to work for our external ... the office. Requirements: * 5+ years of experience in medical billing and claims processing, and insurance...claims to both private and public insurance carriers, including Medicare , Medicaid, and commercial plans. * Investigate and resolve… more
- Humana (Albany, NY)
- …clinical reference materials, internal teaching conferences, and other reference sources. Medical Directors will learn Medicare , Medicaid, and Medicare ... clinical group practice management. + Utilization management experience in a medical management review organization, such as Medicare Advantage, managed… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …case planning and research, conducting onsite or desk audits, clinical reviews of medical records to ensure correct billing of services and appropriateness of ... Level I + Functions as a clinical reviewer of medical records, researching and investigating complex medical ...detection reports and claims data to identify red flags/aberrant billing patterns. + Manages cases as assigned, prioritizing case… more
- Mount Sinai Health System (New York, NY)
- …and compliance of the organization and bridges the gap between clinical care and medical billing and reimbursement. This position will report to the Senior ... health system facility or multi-entity revenue cycle environment. ? Extensive knowledge of medical billing software and electronic medical records. Must have… more
- University of Rochester (Rochester, NY)
- …residents, and staff, covering essential topics such as coding, compliance with Medicare , Medicaid, and third-party payer billing regulations, and fraud, waste, ... **There are two pathways for the Compliance Analyst II (1: Compliance Billing , Coding, and Education Analyst,** **or** **2: Compliance Specialist):** **1: Compliance… more