- MVP Health Care (Schenectady, NY)
- …Integrity & Cost Containment** to lead enterprise-wide initiatives that ensure claims are paid accurately, ethically, and efficiently. This high-impact role ... goals. + Oversee pre- and post-payment integrity programs including claims editing, audits, subrogation, readmission reviews, and coordination of benefits.… more
- Rochester Regional Health (Rochester, NY)
- …clear and concise appeal. Collections Management Responsibilities will include basic knowledge of medical billing , medical claims processing and accounts ... receivable collections. The Medical collection specialist must have the Ability to learn and... must have the Ability to learn and understand medical billing protocol and reimbursement issues, work… more
- Highmark Health (Albany, NY)
- …all related internal, concurrent, prospective and retrospective coding audit activities. Reviews medical records to determine data quality and accuracy of coding, ... billing and documentation related to DRGs, APCs, CPTs and...steps to effect resolution. (10%) + Reviews and interprets medical information, classifies that information into the appropriate payor… more
- Molina Healthcare (Syracuse, NY)
- …activities with other departments in Molina including Finance, Revenue analytics, Claims and Encounters, and Medical Directors + Maintains professional ... chart reviews and abstracts diagnosis codes + Develop an understanding of current billing practices in provider offices to ensure that diagnosis and CPT codes are… more
- Trinity Health (Rensselaer, NY)
- …testing in timely fashion with proper documentation. - Works in colaboration with Billing Analyst on denied claims for missing prior authorization or referral ... pre-certification process. Care Coordination - Confirms payer is in-network with specialist . If not, contacts patient to discuss and make alternate arrangements… more