• Clm Resltion Rep III, Hosp/Prv

    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
    University of Rochester (08/07/25)
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  • Clm Resltion Rep IV, Hosp/Prv

    University of Rochester (Rochester, NY)
    …Microsoft Word, Excel, Access, Email, Emdeon (Fidelis Medicaid Managed Care and Medicare Part B) clearinghouse software, third party claims systems (ePaces, Omnipro) ... and various payer web sites. **Typical Duties:** 30% Complex, High Dollar & Specialized Services Account Resolution + Through detailed knowledge of all third-party payer billing requirements and governmental contracts, independently determines the most… more
    University of Rochester (08/07/25)
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  • Dental Access Rep III

    University of Rochester (Rochester, NY)
    …purposes. Ensures 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. + Schedules new and return visits using the electronic medical record. Monitors schedules and reports problems to Supervisor. Pre-registers patients for next visit and coordinates appointments for ancillary… more
    University of Rochester (08/07/25)
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  • Clm Resltion Rep III, Hosp/Prv

    University of Rochester (Rochester, NY)
    …and all audits + Coordinate responses and resolution to Medicaid and Medicare credit balances. + Request insurance adjustments or retractions. + Review and ... work all insurance credits in EPIC. + Enter EPIC note documenting action taken. 10% Research and respond to third party correspondence, receive phone calls, explain policies and procedures involving routine and non-routine situations. Assist with patient… more
    University of Rochester (08/07/25)
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  • Patient Care Technician - PCT - Dialysis Preceptor

    Fresenius Medical Center (Montebello, NY)
    …certification as defined by Center for Medicaid/ Medicare (CMS)Allappropriatestatelicensure,education,andtraining(ifany) required. + Demonstrated commitment to ... organization culture, values, and customer service standards + Attendance and active participation in all applicable preceptor training programs as established by education leadership + Attends Fresenius and publicly offered skill-based training as assigned by… more
    Fresenius Medical Center (08/04/25)
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  • Community Relations Specialist - Bilingual Spanish

    Centene Corporation (Latham, NY)
    …within 90 days of employment) - If required by the Business Unit/Department **For Medicare only:** Travel up to 80% Must be willing to travel within assigned ... territory. Pay Range: $55,100.00 - $99,000.00 per year Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to… more
    Centene Corporation (08/03/25)
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  • Unit Clerk

    Dialysis Clinic, Inc. (Staten Island, NY)
    …and ensures the patients' charts are in order in accordance with Medicare and company policies and procedures. **Schedule** : Full-time, five 8-hour shifts ... starting at 8am; Sundays off; no overnight shifts **Compensation** : Pay range from $18-$24 per hour, depending on qualifications and experience **Benefits** : + Comprehensive medical, dental and vision benefits + Life and long-term disability insurance… more
    Dialysis Clinic, Inc. (08/03/25)
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  • Network Optimization Coordinator

    CDPHP (Albany, NY)
    …as assigned Qualifications: + 3 years managed care experience with commercial, Medicare and Medicaid lines of business and regulatory requirements + Associates ... degree or two (2) years of equivalent experience required. + 1-3 years contract management experience preferred + Negotiation experience preferred + Demonstrated proficiency in Word, Excel, and PowerPoint + Understanding of legal and regulatory contract… more
    CDPHP (08/03/25)
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  • Program Director, Quality Improvement (Remote)

    Molina Healthcare (Rochester, NY)
    …experience with HEDIS programs. + 2 years Medicaid experience + 2 years Medicare experience + 3 years management experience + Operational knowledge and experience ... with Excel and Visio (flow chart equivalent). + Proficiency with data manipulation and interpretation. + NCQA Accreditation experience. **Preferred Education** Master's Degree or higher in a clinical field, IT, Public Health or Healthcare Administration.… more
    Molina Healthcare (08/02/25)
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  • Community Living Case Manager (QIDP)/Intake…

    Living Resources (Albany, NY)
    …program and necessary admission/discharge requirements + Knowledge of Medicaid, Medicare , SNAP and Social Security benefits and applications/certifications for each ... + Gather necessary documents for all new admissions + Ensure changes to individual's service authorizations and amendments are submitted to OPWDD + Collaborate with the finance department and benefit specialists to troubleshoot issues impacting billing and… more
    Living Resources (08/02/25)
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