- Catholic Health Services (Smithtown, NY)
- …college level is highly desirable. Skills, Knowledge or Abilities: Knowledge of Medicare , Medicaid and insurance required. Must have troubleshooting skills and the ... ability to work independently. Experience: Computer experience required. Three to five years' experience required. DUTIES/RESPONSIBILITIES: Performs monthly review of designated payer accounts Processing of mail/EOB's for the facility Verified residents… 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
- Stony Brook University (East Setauket, NY)
- …hospital Managed Care payment variances and denials. + Expert knowledge of Medicare and NY Medicaid Inpatient and Outpatient reimbursement methodologies. + Expert ... knowledge of third party reimbursement methodology and associated healthcare claim drivers. + Expert knowledge of inpatient and outpatient billing requirements (UB-04, 837i). + Experience working with CPT, HCPCs and ICD-10 codes. + Experience working with… more
- YAI (Manhattan, NY)
- …agencies (Office for People with Developmental Disabilities (OPWDD), Centers for Medicare and Medicaid Services (CMS), Office of Medicaid Inspector General (OMIG), ... Department of Health (DOH)), etc. + Develops monitoring tools and checklists for use in internal audits to assess compliance with applicable regulations and identify areas of concern in preparation for external audits. + Supports program leadership with… more
- Stony Brook University (Commack, NY)
- …settlement discussions, and reimbursement escalations. + Ensure compliance with Medicare and Medicaid reimbursement methodologies and stay current on commercial ... and government changes affecting the organization. + Monitor and dispute Managed Care payer reimbursement policies or practices that breach contract terms, track resolution outcomes. + Oversee facility credentialing process. + Maintain comprehensive knowledge… more
- Mount Sinai Health System (New York, NY)
- …procurement of financial assistance for patients with government-sponsored health plans including Medicare , Medicaid and TriCare. Preferred: 3 years of health care ... related billing and benefits investigation 1 year of retail pharmacy experience 1 year of PBM payer operations 1 year of hospital/institutional pharmacy Non-Bargaining Unit, 600 - HSO Pharmacy - MSH, Mount Sinai Hospital **Responsibilities** 1.Organizes the… more
- University of Rochester (Rochester, NY)
- …purposes. Assures completion of all appropriate forms by patients, such as, Medicare Secondary Payer assurance, provision of HIPAA information for new patients, ... requesting patient identification to verify identity. - Appointment Scheduling: Schedules new and return visits using the electronic medical record, monitors schedules and reports problems to Supervisor, pre-registers patients for next visit, coordinates… more
- University of Rochester (Rochester, NY)
- …the ability to be independently paneled by major insurance companies including Medicare and Commercial insurers. The University of Rochester is committed to ... fostering, cultivating, and preserving an inclusive and welcoming culture to advance the University's Mission to Learn, Discover, Heal, Create - and Make the World Ever Better. In support of our values and those of our society, the University is committed to… more
- Charles B. Wang Community Health Center (Queens, NY)
- …& Disabled population individuals into the relevant Medicaid program with Medicare eligibility assessments + Assure that application is accurately completed and ... adhering to submission deadline dates + Attend internal and external trainings and meetings + Understand overall eligibility requirements for government-sponsored health insurance programs + Maintain timely knowledge of government-sponsored health insurance… more
- University of Rochester (Albany, NY)
- …and all audits. Coordinates response and resolution to Medicaid and Medicare credit balances. Requests insurance adjustments or retractions. Reviews and works ... all insurance credits in electronic health record. Enters electronic health record notes, documenting actions taken. + Researches and responds to third party correspondence, receives phone calls, and explains policies and procedures involving routine and… more