- New York State Civil Service (NY)
- …in orientation and mentoring of new RNs and LPNs.*Complete evaluations.*Monitor/Complete nursing audit for the cluster, work closely with the Nursing Supervisor / ... complete: a review of the medical section Life Plan/CFA, medication audit (each home/day program).*Participates in Nurse on call rotation.*Obtain individual's… more
- Molina Healthcare (Albany, NY)
- …MCG, InterQual or other medically appropriate clinical guidelines, Medicaid, Medicare , CHIP and Marketplace, applicable State regulatory requirements, including the ... + Active and unrestricted Certified Clinical Coder + Certified Medical Audit Specialist + Certified Case Manager + Certified Professional Healthcare Management… more
- Bassett Healthcare (Milford, 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
- MVP Health Care (Rochester, NY)
- …**Your key responsibilities:** + Lead audits such as DOH, SOC, and Model Audit Rule (MAR) + Analyze and interpret data from Commercial, On/Off-Exchange, and ... Medicare reports + Participate in and play a lead role in project meetings and initiatives + Develop and manage testing plans for system enhancements and invoice… more
- Northern Rivers Family Services (Troy, NY)
- …with county and community partners, and participate in any quality audit and utilization review + Provide on-site/community based/home visits, medication ... get: + National Provider Identification (NPI)- issued by the federal Center for Medicare and Medicaid Services (CMS). All electronic prescriptions in NYS require an… more
- City of New York (New York, NY)
- …of Homeless Services (DHS). DSS-AO maintains the operation of the Office of Audit Services (OAS) and Office of Quality Assurance (OQA), Office of Accountability ... spending. This work includes identifying Medicaid clients who should apply for Medicare , identifying Medicaid clients who should be part of buy-in program, and… more
- Humana (Albany, NY)
- …+ Familiarity with compliance standards, HR data governance, and system audit -readiness. **Preferred Qualifications** + MBA or other Advanced Degree + Demonstrated ... efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities at large. … more
- Humana (Albany, NY)
- …+ Familiarity with compliance standards, Finance data governance, and system audit -readiness. **Preferred Qualifications** + MBA or other Advanced Degree + ... efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities at large. … more
- Stony Brook University (East Setauket, NY)
- …and trend analyses via spreadsheets, databases and dashboards. + Create audit and reconciliation plans related to: charges, adjustments, expected reimbursement and ... + Experience with inpatient and outpatient billing requirements (UB-04) and CMS Medicare and New York Medicaid reimbursement methodologies. + Knowledge of third… more
- Kaleida Health (Buffalo, NY)
- …reports, participation in the preparation of Kaleida Health and affiliate cost reports, audit tools, and other required submissions. Supports Medicare , NYS DOH ... and other audits as requested. Prepares analysis and participates in special projects as required from time to time for the Reimbursement and Revenue Analysis area of the Finance department.** **Education And Credentials** **HS - High School Diploma or GED.… more