- 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
- Healthfirst (NY)
- …of work for the position. + Participate in regulatory and mock audit activities including universe review, universe scrubbing, risk analysis, timeliness assessment, ... + Knowledge of at least two or more lines of business such as Medicare NY/NJ, Medicaid, Family Health Plus, Child Health Plus, NH Family + Experience handling… more
- CenterLight Health System (NY)
- …Assist management with timely and accurate response to internal and external audit inquiries, including government agencies. + Other duties as assigned. Schedule: ... of claims PPS is strongly preferred. + Knowledge of Medicaid and Medicare benefits, enrollment and billing, and provider contracting is strongly preferred. +… more
- WMCHealth (Valhalla, NY)
- …+ Researches technical guidance in UB-92 Editor, CPT/HCPCs Guide, CMS website, Medicare Manuals, etc. to resolve billing issues and promote regulatory compliance. + ... status of audits and issues presented. + Participates in quantifying audit outcomes, including revenue realized + Researches and communicates appropriate treatment… more
- New York State Civil Service (NY)
- …for everyone in your caseload, completes: review of medical section ISP, medication audit (each home). * Keeps up to date regarding changes to medical section ... and maintain eligibility for full and unconditional participation in the Medicare and Medicaid programs. Continued employment will depend on maintaining eligibility.… more
- Centers Plan for Healthy Living (Staten Island, NY)
- …Manager + To provide support and training for representatives once identified during the audit in the field + To collaboratively work with managers to ensure each ... paced environment + Managed long term care knowledge + Medicaid knowledge + Medicare knowledge SCOPE INFORMATION # Direct Reports: Training and Development Manager -… more
- WMCHealth (Hawthorne, NY)
- …compliance with detailed requirements, guidelines, and deadlines of Centers for Medicare & Medicaid Services, National Committee for Quality Assurance (NCQA), ... relevant national databases and organizations, conducts reference checks and malpractice audit history + Requests documentation, follows up on receipt of required… more
- Mohawk Valley Health System (Utica, NY)
- …payor review in collaboration with attending physicians. + Support Recovery Audit Contractors (RAC's). + Assist with mitigating barriers to discharge and ... clinical variability throughout the medical staff. + Assist case managers with Medicare and Medicaid appeals and Administrative Law Judge (ALJ) testimonies. Act as… more
- University of Rochester (Rochester, NY)
- …drugs (HazD) in compliance with USP 800 standards, Centers for Medicare and Medicaid Services┐ Conditions of Participation, Department of Health regulations, ... maintained in a current state, and all sites remain in a ready for audit /inspection state. Serves as the chair for the Hazardous Drug Steering Committee. JOB DUTIES… more