- New York State Civil Service (Rochester, NY)
- …statistical reports on facility activities and patient progress for program audit and evaluation, third party reimbursement, and program reporting units.* Protect ... eligibility for full and unconditional participation in the Medicaid and Medicare programs. Failure to maintain licensure, certification and Medicaid/ Medicare … more
- Evolent (Albany, NY)
- …of utilization review determinations, including appeals. + Provides input into audit processes including development of questions. + Reviews statistical sample of ... by any state or federal health care program, including Medicare or Medicaid, and is not identified as an...General Service Administration (GSA), or reprimanded or sanctioned by Medicare . + No history of a major disciplinary or… more
- Datavant (Albany, NY)
- …materials + Provide support to client relations for trainings needed for client audit findings + Research and analysis of coding error trends What you will ... and understanding of HCC mapping and models + Experience with coding Medicare , Commercial and Medicaid risk adjustment charts + Understanding of Medicare… more
- Trinity Health (Syracuse, NY)
- …standards while adhering to coding guidelines established by the Centers for Medicare and Medicaid Services (CMS). Excellus contract specific RA Coding Specialist ... with educational needs determination and communication to the Supervisor, RA Coding & Audit . Key contributor duties related to CCD/HCC and other Risk Adjustment… more
- Northwell Health (Lake Success, NY)
- …of care provided. Responsible for concurrent inpatient medical record reviews for Medicare , Medicaid and all commercial payers. Generates queries and have follow up ... for file maintenance including entry into database for tracking and trending audit results. Communicate findings of potential or missed diagnoses and the revenue… more
- Bassett Healthcare (Oneonta, NY)
- …is entered or scanned into the system accurately as monitored by system audit Accurate confirmation of attending PCP and Billing PCP, when appropriate. Assures ... of Advanced Beneficiary Notice signatures and form processing to meet Medicare regulations. Ensures all corrections (demographics, insurance eligibility etc.) based… more
- Bassett Healthcare (Cooperstown, NY)
- …is entered or scanned into the system accurately as monitored by system audit Accurate confirmation of attending PCP and Billing PCP, when appropriate. Assures ... of Advanced Beneficiary Notice signatures and form processing to meet Medicare regulations. Ensures all corrections (demographics, insurance eligibility etc) based… more
- Mohawk Valley Health System (Utica, NY)
- …EDUCATOR Department: MEDICAL GROUP ADMINISTRATION Job Summary The Supervisor Coding Audit and Education is responsible for overseeing medical coding accuracy, ... of experience as a medical coder, with at least 1 year in a coding audit or educator role. + In-depth knowledge of compliance standards, including HIPAA, HITECH, and… more
- City of New York (New York, NY)
- …Program, Management Benefits Fund, Employee Assistance Program, Work Well NYC, Medicare Part B Reimbursement and Pre-Tax Benefits & Citywide Programs including ... rules, laws and policies and oversight of the agency's pre audit hiring and post audit promotions/salary adjustments plans. - Implement personnel actions for new… more
- CenterLight Health System (NY)
- …and implementation of cost saving initiatives. + Lead department in responding to audit inquiries, including closing the loop on any potential Corrective Action Plan ... practice managers, and coders to submit claims appropriately and timely. + Audit billing and collection procedures to ensure accuracy and compliance with… more