- Excellus BlueCross BlueShield (Rochester, NY)
- …for coordinating, integrating, and monitoring the utilization of physical health (PH) medical and healthcare services for members, ensuring compliance with ... standards set by regulatory and accreditation entities. Refers appropriate cases to the Medical Director for review. Refer to and work closely with Case Management… more
- Robert Half Accountemps (Brooklyn, NY)
- …ideal candidate will play a key role in managing invoice processing, coding , and payment preparation to ensure smooth financial operations. This position requires ... * Process and verify invoices to ensure accuracy and compliance with company policies. * Assign appropriate codes to...payments. * Collaborate with internal teams to ensure proper coding and approval workflows. * Monitor payment schedules and… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …the utilization of behavioral health (BH) services for members, ensuring compliance with internal and external standards set by regulatory and accreditation ... entities. Refers appropriate cases to the Medical Director for review. Refer to and work closely...health plan benefits, and efficient care delivery processes. Ensures compliance with corporate and departmental policy and procedure, identifies… more
- MVP Health Care (Rochester, NY)
- …you have a passion for problem solving and investigations, commitment to compliance and ethical standards and dedication to continuous learning and improvement. ... to the above requirements: A duly licensed or authorized medical professional, including but not limited to MD or...CPC and/or COC credential. + Maintain nursing license and coding credentials through continuing education process as required. +… more
- Hudson Headwaters Health Network (Queensbury, NY)
- …health care services. Physicians function within their scope to provide high-quality medical care across a variety of settings that comprise Hudson Headwaters Health ... team. Physicians also must be able to effectively communicate with the senior medical directors and providers as well as other personnel. Physicians are responsible… more
- Mohawk Valley Health System (Utica, NY)
- …The Physician Advisor (PA) conducts clinical review of cases to ensure compliance with regulatory requirements, hospitals objectives, and quality patient care while ... planning, patient status changes, length of stay, patient monitoring practices, medical necessity concepts and associated regulations in case management decisions.… more
- Catholic Health Services (Commack, NY)
- …as assigned. Compliance /HIPAA + Implementation and monitoring to ensure the Medical Group physician practices are in compliance with CHS policies, ... direction, and ongoing administration and management for all aspects of the assigned medical offices of the CHS Physician Medical Group. The Site Director… more
- Robert Half Finance & Accounting (New York, NY)
- …Revenue Cycle to oversee and optimize all facets of billing, collections, coding , and credentialing operations. This role is pivotal in driving efficiency, ensuring ... compliance , and aligning revenue cycle strategies with overarching organizational...mentor the revenue cycle team, ensuring all billing, collections, coding , and credentialing processes run efficiently. * Develop and… more
- Mount Sinai Health System (New York, NY)
- …analyze data for trends and improvement opportunities, and ensure accuracy, compliance , and efficiency throughout the revenue cycle. The Director will report ... as well as proficiency in data analysis, financial management, healthcare coding , and understanding of regulatory requirements. + Certification in Epic Clarity… more
- Wells Fargo (New York, NY)
- …cloud-native applications using modern frameworks and technologies + Do hands-on coding and software development to create high-quality, scalable applications + Lead ... architecture thought leadership to the team. + Ensure best practices in coding , architecture, and security are followed. + Collaborate with cross-functional teams to… more
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