- MVP Health Care (Albany, NY)
- …plans including Medicaid, Child Health Plus, Essential Plan, QHPs, HARP, Off-Exchange, Medicare Advantage , and D-SNP. **Qualifications you'll bring:** + Two plus ... years of customer service or sales experience, ideally in health care (hospital, medical office, or insurance). + Associate's degree or equivalent combination of education and experience. + Bilingual skills (eg, English and Spanish) are a plus. + Valid… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …reviews and audits utilizing knowledge and experience of ICD-9-CM/ICD-10-CM coding, Medicare Advantage and Commercial Hierarchical Condition Category (HCC) ... coding, and Medicaid Clinical Risk Groups (CRGs) to ensure compliance. * Assist in developing, implementing, evaluating and updating desktop processes, policies and procedures and business rule tools governing the response to Risk Adjustment Data Validation… 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 MSHP's subject matter experts on: Facility related Agreements and Amendments, financial performance for all contracts, and facility, ancillary related contract negotiations. The Managed Care Team is at the forefront of implementing Facility and Ancillary… more
- Molina Healthcare (NY)
- …+ Exposure to Databricks, Spark, or similar data platforms + Familiarity with Medicare Advantage or Medicaid programs + Awareness of CMS audit processes ... or healthcare compliance requirements **Ideal Candidate Attributes** + **Curious and Eager to Learn** : Interested in understanding healthcare data and willing to dig into unfamiliar topics. + **Team-Oriented** : Works well in a collaborative environment and… 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 MSHP's subject matter experts on: Facility related Agreements and Amendments, financial performance for all contracts, and facility, ancillary related contract negotiations. The Managed Care Team is at the forefront of implementing Facility and Ancillary… more
- MVP Health Care (Tarrytown, NY)
- …Plan (EP), HARP, On-Exchange Qualified Health Plans (QHP), Off-Exchange Plans, and Medicare Advantage plans to individuals at Federally Qualified Health Centers ... (FQHCs), medical provider offices, Community Based Organizations (CBOs), WIC Centers, churches, and schools. + Conduct regularly scheduled team meetings with staff. + Complete outreach site schedule and ensure it is updated and entered into Bookings scheduling… more
- TEKsystems (Rochester, NY)
- TEKsystems' client in the Rochester, NY area is hiring 30+ commercial and medicare insurance customer service agents on a contract basis. This will be a 100% remote ... customer service or call center environment + Familiarity with Medicare and commercial insurance is a plus + Ability...We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are… more
- New York State Civil Service (Tarrytown, NY)
- …from appointment.You are responsible for payment of all required fees.Medicaid and Medicare : In order to be eligible for appointment and to maintain employment, ... on any of the Federal and/or State Medicaid and Medicare exclusion lists (or excluded from any other Federal...as Health Care Spending Account and the Dependent Care Advantage Account offer employees options to pay for uncovered… more
- New York State Civil Service (Staten Island, NY)
- …individual or entity on any of the Federal and/or State Medicaid and Medicare exclusion lists (or excluded from any other Federal or Federally assisted program). ... appointed, you may be required to become an enrolled Medicare provider; obtain and provide to your employer a...as Health Care Spending Account and the Dependent Care Advantage Account offer employees options to pay for uncovered… more
- New York State Civil Service (NY)
- …individual or entity on any of the Federal and/or State Medicaid and Medicare exclusion lists (or excluded from any other Federal or Federally assisted program). ... appointed, you may be required to become an enrolled Medicare provider; obtain and provide to your employer a...as Health Care Spending Account and the Dependent Care Advantage Account offer employees options to pay for uncovered… more