- Intermountain Health (Albany, NY)
- …and compliant application with charge/coding capture, charge editing, and audit and reimbursement practices. Researches and collaborates on regulation updates ... preceptor, trainer experience is preferred Knowledgeable of CMS Guidelines ( Medicare /Medicaid) To perform this job successfully, an individual must be able… more
- Humana (Albany, NY)
- …operational goals, including regulatory compliance requirements + Promotes and builds an " Audit Ready Every Day" culture + Further simplifies and improves processes ... efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities at large. … more
- YAI (Manhattan, NY)
- …by Quality and Compliance department and/or for any other program or financial audit or review. + Performs a variety of clerical, administrative and financial tasks ... and entitlements in the healthcare and/or I/DD field including Medicaid, Medicare and applicable regulatory agencies. + Strong written and oral communication… more
- Bard College (Annandale On Hudson, NY)
- …requirements and monitoring the plan for compliance, including managing the annual audit ; and + prepare reports and conduct analysis. PREFERRED COMPETENCIES AND ... but not limited to ACA, ADA, COBRA, ERISA, FMLA, PFL, OSHA, Medicare , Social Security, workers compensation, and DOL requirements; + strong project management… more
- YAI (Manhattan, NY)
- …of timely and accurate bill processing through commercial insurance, Medicare and/or Medicaid and assessing eligibility for medical/clinical services received ... May assist with or collect data to support coordination of responses to audit requests received from external sources within required time frames, including year-end… more
- Humana (Albany, NY)
- …+ Building working relationships with internal stakeholders and supporting external audit preparation efforts. + Demonstrating an understanding of departmental and ... efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities at large. … more
- Cardinal Health (Albany, NY)
- …for reporting any payer issues to the appropriate team + Must self- audit activities to ensure accuracy and efficiency for the program **_Qualifications_** + ... benefit investigations, prior authorizations, and appeals, preferred + Knowledge of Medicare , Medicaid and Commercially insured payer common practices and policies,… 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
- Excellus BlueCross BlueShield (Buffalo, NY)
- …read assignments. May support vendor discussions and feedback related to quality audit findings. Presents results and learning opportunities to the team. * Serves ... and audits utilizing knowledge and experience of ICD-9-CM/ICD-10-CM coding, Medicare Advantage and Commercial Hierarchical Condition Category (HCC) coding, and… more
- Molina Healthcare (Syracuse, 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