- Kaleida Health (Buffalo, NY)
- **Reimbursement Analyst ** **Location:** **Larkin Bldg @ Exchange Street** **Location of Job** **: US:NY:Buffalo** **Work Type** **: Full-Time** **Shift 1** **Job ... and affiliate cost reports, audit tools, and other required submissions. Supports Medicare , NYS DOH and other audits as requested. Prepares analysis and participates… more
- WMCHealth (Valhalla, NY)
- Revenue Integrity Analyst Company: NorthEast Provider Solutions Inc. City/State: Valhalla, NY Category: Clerical/Administrative Support Department: Revenue Integrity ... Internal Applicant link Job Details: Job Summary: The Revenue Integrity Analyst reviews and revises accounts to achieve revenue enhancement and compliance.… more
- MVP Health Care (Rochester, NY)
- …improvement. To achieve this, we're looking for a **Professional, Sr. Risk Adjustment Analyst ** to join #TeamMVP. This is the opportunity for you if you have ... of CMS risk adjustment and reinsurance payment processes and audits for Medicare and Commercial programs required + Experience in risk adjustment payment models… more
- Humana (Albany, NY)
- …and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business Intelligence Engineer will be an integral ... efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities at large. … 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 ... Sinai Health System. MSHP seeks a Senior Contract Compliance (Hospital Billing) Analyst who will primarily be responsible for tracking, trending, and analyzing… 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 ... across the Mount Sinai Health System. MSHP seeks a **Senior Contract Manager Analyst ** will play a critical role in testing, coding, modeling, and reporting on… more
- Healthfirst (NY)
- …been responded to. + Provides support to all internal stakeholders during the annual Medicare Go to Market project in preparation for the Medicare Annual ... Requirements:** + BA/BS from an accredited institution + Knowledge of Medicare Communications and Marketing Guidelines, New York State Managed Long-Term Care… more
- CVS Health (Albany, NY)
- …Investigative experience + Marketplace Broker Investigative experience + Medicaid and Medicare experience **Education** + Bachelor's degree in Criminal Justice or ... equivalent experience **Anticipated Weekly Hours** 40 **Time Type** Full time **Pay Range** The typical pay range for this role is: $46,988.00 - $112,200.00 This pay range represents the base hourly rate or base annual full-time salary for all positions in the… more
- Molina Healthcare (Rochester, NY)
- …and set up complicated proof of concept tests without needing mentoring + Eg, Medicare Exclusion POC + Acts as a team lead, assigning and prioritizing work for ... other team members as needed. **JOB QUALIFICATIONS** **Required Education** Bachelor's Degree or equivalent combination of education and experience **Required Experience** 5-6 Years **Preferred Education** Graduate Degree or equivalent experience **Preferred… more
- Centene Corporation (New York, NY)
- …disenrollment compliant audits, providing examples of any gaps that could change our Medicare STAR rating by H-contract. Able to interpret and understand changes to ... voluntary disenrollment logics according to CMS requirements. * Leads in the support of business initiatives through CMS STAR rating trend analysis via TRR, identification of membership reasons for disenrollment and recommend opportunities for process… more