- SUNY Upstate Medical University (Syracuse, NY)
- …to clinical practice is also required. + Have an NPI number and be Medicare Identification Number (or PTAN) (or eligible for Medicare Enrollment within 6 ... months of hire. + CPR-BLS Certification required at the time of appointment. + Must successfully pass pre-employment and credentialing clearances. Preferred Qualifications: + 1-2 years Inpatient experience + Palliative Care experience Work Days: + Monday -… more
- Rochester Regional Health (Rochester, NY)
- …+ Check insurance eligibility via appropriate websites. + Complete the Medicare Secondary Payer Questionnaire for eligible patients. + Complete all required ... Medicare admission forms. + Verify third-party and Worker's Compensation benefits as per policy. + Collect copays, co-insurance, and deductibles at registration. +… more
- Stony Brook University (Stony Brook, NY)
- …within thirty days. Documents over utilization of resources and services. + All Medicare cases are reviewed for level of care on admission. Reviews with the ... does not meet in-patient criteria for admission. Follows the process for Code 44 on Medicare patients. Follow the process for Code 44 on all other payers. + Active… more
- Mount Sinai Health System (New York, NY)
- …physician service charges to ensure they align with payer regulations, Medicare /Medicaid reimbursement methodologies, and managed care contracts. + Provides routine, ... coding guidelines and compliance regulations set by entities like the Centers for Medicare and Medicaid Services (CMS). + Mitigate the risk of compliance violations,… more
- 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 ... to analyze and report the financial performance for all Commercial and Medicare Contracts with Mount Sinai. The Senior Contracting Analyst has responsibilities that… more
- Humana (Albany, NY)
- …+ Previous experience with pharmacy benefits management + Previous Commercial, Medicare and/or Medicaid experience + 3 or more years clinical experience ... efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities at large. … more
- University of Rochester (Rochester, NY)
- …volume and provide guidance and quality assurance of work. _Compliance_ + Review Medicare for MSP questions and validations. + Ensure compliance with the Office of ... the Inspector General guidelines by notifying patients of exhausting Medicare benefits and the option to utilize lifetime reserve days. + Ensure appropriate… more
- Access: Supports For Living (Middletown, NY)
- …various payers' portals. + Maintain a working knowledge of OMH, OASAS, Medicare , Medicaid, Medicaid Managed Care and other payers' billing regulations for all ... team. + Knowledge of Medical Insurance programs such as Medicaid, Medicare and Dual eligibility benefits establishment. + Experience with automated billing… more
- Molina Healthcare (Buffalo, NY)
- …State (TX) Medical License, free of sanctions from Medicaid or Medicare . **Preferred Experience** * Peer Review, medical policy/procedure development, provider ... contracting experience. * Experience with NCQA, HEDIS, Medicaid, Medicare and Pharmacy benefit management, Group/IPA practice, capitation, HMO regulations, managed… more
- Sodus Rehab & Nursing Center (Medina, NY)
- …resident, staff and family education and in-servicing + Demonstrates working knowledge of Medicare Part A PPS case management + Complies with Federal and State ... Participates in internal audits as directed + Possess a strong knowledge of Medicare , Medicaid and other payment sources and their responsibility in the SNF setting… more