- Excelsior Orthopaedics Group (Amherst, NY)
- …Epic, or similar) is required. + Comprehensive knowledge of commercial, Medicare , Medicaid, and workers' comp billing procedures preferred. + Strong analytical ... skills to interpret EOBs, address denials, and resolve account discrepancies preferred. + Demonstrated attention to detail, time management, and organizational abilities. + Effective interpersonal and communication skills for interactions with patients and… more
- CVS Health (Albany, NY)
- …health advocacy team looking for dedicated friendly colleagues to help the Medicare population learn about and complete important health screenings and activities. ... As a Health Advocate on the Healthy Outcomes Team, you will interact with members telephonically to inspire healthy behaviors. Our goal on each call is to give every member a clear understanding of their benefits for specific screenings and medications. You… more
- Molina Healthcare (Buffalo, NY)
- …National Committee of Quality Assurance (NCQA) guidelines, and Centers for Medicare and Medicaid Services (CMS) standards. * Provides coordination and processing ... of pharmacy prior authorization requests and/or appeals. * Explains point-of-sale claims adjudication, state, NCQA and CMS policies/guidelines, and any other necessary information to providers, members and pharmacies. * Assists with clerical tasks and other… more
- Humana (Albany, NY)
- …efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities at large. ... **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic… more
- Fresenius Medical Center (Amsterdam, NY)
- …School diploma or GED required. + Must meet Center for Medicaid/ Medicare Services (CMS)-approved state and/or national certification requirements within the required ... state or CMS timeline. + All appropriate state licensure education and training (if any) required. **EXPERIENCE AND REQUIRED SKILLS:** + At least two years previous patient care experience in a hospital setting or a related facility preferred. + Continued… more
- University of Rochester (Rochester, NY)
- …to resolution. + Provides support regarding payer audits, including quarterly Medicare and Medicaid Credit Balance reports and additional credit balance reports ... issued by external partners. + Reconciles client billing on a monthly basis. + Assists with credit balance work queues as needed. + Recommends improvements to policies and procedures. Assists with the review of existing policy and procedure manuals. Other… more
- Fresenius Medical Center (Troy, NY)
- …assist" devices for the heavier items. **EDUCATION** + Center for Medicaid/ Medicare Services (CMS)-approved state and/or national certification or High School ... diploma or GED and must meet certification requirements within the required state or CMS timeline. + All appropriate state licensure, education and training (if any) required. **EXPERIENCE AND REQUIRED SKILLS** + Previous patient care experience in a hospital… more
- Bayer (Manhattan, NY)
- …and decision drivers of US commercial and government payers (Commercial, Medicare Part B/D, Medicaid) and channel customers (eg, specialty pharmacy and ... distribution, GPOs, 340B); + Demonstrated experience in driving market access and pricing strategy implementation, including crafting compelling value propositions and evidence generation plans; + Strong commercial and financial acumen, with a deep… more
- Humana (Albany, NY)
- …efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities at large. ... **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic… more
- MVP Health Care (Columbia County, NY)
- …Health Plus, Essential Plan, Qualified Health Plans (QHPs), HARP, Off-Exchange, Medicare Advantage (MA) products, and Dual Eligible Special Needs Plans (D-SNP). ... + **Conduct both individual and group outreach activities** to present our innovative health care solutions on- and off-site at various events-from health fairs and community expos to festivals and holiday-themed gatherings-ensuring MVP's presence is both seen… more