• Specialist, Corporate Credentialing

    Molina Healthcare (NY)
    …if providers have sanctions/exclusions. * Reviews and processes monthly daily alerts for Medicare Opt-Out reports to determine if any provider has opted out of ... Medicare . * Reviews and processes assigned daily NPDB Continuous...School Diploma or GED **Required Experience/Knowledge Skills & Abilities:** Certified Provider Credentialing Specialist (CPCS) or participation in a… more
    Molina Healthcare (07/19/25)
    - Related Jobs
  • RN Case Manager

    Stony Brook University (Stony Brook, NY)
    …within thirty days. Documents over utilization of resources and services. + All Medicare cases are reviewed for level of care on admission. Reviews with the ... for admission. Follows the process for Code 44 on Medicare patients. Follow the process for Code 44 on...MCG Certification Working knowledge of MCG or Interqual PRI Certified Knowledge of regulatory requirements Bilingual Recent experience in… more
    Stony Brook University (07/16/25)
    - Related Jobs
  • Occupational Therapist

    Sodus Rehab & Nursing Center (Massena, NY)
    …progress notes and re-certifications per facility policy. + Supervises Certified Occupational Therapy Assistants and unlicensed assistive personnel + Provides ... resident, staff and family education and in-servicing + Demonstrates working knowledge of Medicare Part A PPS case management + Complies with Federal and State… more
    Sodus Rehab & Nursing Center (07/16/25)
    - Related Jobs
  • Peer Specialist (Oasas) - Hourly (St. Lawrence…

    New York State Civil Service (Ogdensburg, NY)
    …Other job-related duties as assigned. Minimum Qualifications Current certification as a Certified Recovery Peer Advocate (CRPA) or CRPA-Provisional by the New York ... eligibility for full and unconditional participation in the Medicaid and Medicare programs. Failure to maintain Medicaid/ Medicare eligibility will result… more
    New York State Civil Service (07/11/25)
    - Related Jobs
  • Claims Examiner Workers Comp I Remote I SE,…

    Sedgwick (Albany, NY)
    …achieve. Newsweek Recognizes Sedgwick as America's Greatest Workplaces National Top Companies Certified as a Great Place to Work(R) Fortune Best Workplaces in ... limited to: subrogation, Second Injury Fund excess recoveries and Social Security and Medicare offsets. + Reports claims to the excess carrier; responds to requests… more
    Sedgwick (06/29/25)
    - Related Jobs
  • Senior Financial Analyst/CDM Chargemaster…

    Mount Sinai Health System (New York, NY)
    …years of experience in hospital chargemaster maintenance and medical coding. + Certified Professional Coder (CPC) or equivalent credential required + Proficient in ... CPT, HCPCS, revenue codes, and Medicare billing regulations. + Advanced proficiency in Epic, especially...Assist in resolving problems causing payer denial or failed Medicare edits as they involve the chargemaster + Coordinate… more
    Mount Sinai Health System (06/07/25)
    - Related Jobs
  • Speech-Language Pathologist

    Tarrytown Rehabilitation & Nursing Center (Ghent, NY)
    …Pathologist or Clinical Fellow with appropriate supervision from a certified and licensed Speech-Language Pathologist. Valid ASHA certification in Speech-Language ... progress notes and re-certifications per facility policy. + Demonstrates working knowledge of Medicare Part A PPS case management + Complies with Federal and State… more
    Tarrytown Rehabilitation & Nursing Center (06/05/25)
    - Related Jobs
  • OB/GYN - System Medical Director - Ambulatory…

    Mount Sinai Health System (New York, NY)
    …institution also received a Health Care Innovation Award from the Centers for Medicare and Medicaid Services to open the first geriatric emergency department in New ... Accredited University + New York Medical License + Board Certified in OB/GYN + Committed to Mount Sinai and...with NYS Prenatal Care Regulations + Ensure compliance with Medicare Teaching Physicians rules (TPR) - This relates to… more
    Mount Sinai Health System (05/30/25)
    - Related Jobs
  • Director of DevSecOps Automation and Engineering

    Humana (Albany, NY)
    …NIST, BSIMM. * Professional security management certification, such as a Certified Information Systems Security Professional * (CISSP), Certified Information ... 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 (08/15/25)
    - Related Jobs
  • Clm Resltion Rep III, Hosp/Prv

    University of Rochester (Rochester, NY)
    …and all audits + Coordinate responses and resolution to Medicaid and Medicare credit balances. + Request insurance adjustments or retractions. + Review and ... or Certification obtained from a nationally accredited billing program (ie, Certified Medical Billing Specialist CMBS, Certified Medical Records Technician… more
    University of Rochester (08/07/25)
    - Related Jobs