- Molina Healthcare (Syracuse, NY)
- …technicians to meet departmental and CMS standards. + Enforce HIPAA compliance standards and regulations while maintaining guidelines and other necessary information ... contact information is current and up to date. + Effectively communicate general Medicare and Medicaid plan benefits to existing members. + Interact with appropriate… more
- New York State Civil Service (Bronx, NY)
- …include:* Reviewing clinical records for completeness and accuracy to ensure compliance .* Collecting and analyzing data related to the utilization review process ... review experience in a health care facility regulated by Centers for Medicare and Medicaid Services Utilization Review Standards, or* Possession of a license… more
- Humana (Albany, NY)
- …efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities at large. ... veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to… more
- Weill Cornell Medical College (New York, NY)
- …Processes medical record requests for provider(s), according to institutional and compliance standards. + Obtains, reviews and updates patient demographic and ... coding. + Working knowledge of third party payor reimbursement - Medicare , Medicaid, Managed Care and commercial insurance. **Licenses and Certifications** **Working… more
- Humana (Albany, NY)
- …efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities at large. ... veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to… more
- Humana (Albany, NY)
- …efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities at large. ... veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to… more
- Northwell Health (Amityville, NY)
- …reconcile EOB's that include "withholds" and/or "take backs". + Ensure receipt of Medicare and Medicaid weekly advance RA information. + Process any requests for ... free of hazards. + Employee conducts herself/himself in conformity with HIPPA Compliance program and applicable facility policies and procedures for patient privacy.… more
- Humana (Albany, NY)
- …efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities at large. ... veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to… more
- Kelly Services (Rochester, NY)
- …required + Review and interpret prescription and medical benefit coverage (including Medicare D); document necessary information for clinical staff + Develop and ... and claims systems interface + Triage daily workflow, monitor queues, monitor compliance deadlines, and communicate with management + Provide phone support for UM… more
- Northwell Health (New Hyde Park, NY)
- …of relevant experience, required. Preferred Experience + In-depth knowledge of Medicare and Medicaid billing regulations, guidelines, and compliance requirements ... (eg, medical necessity, Local Coverage Determinations (LCDs), National Coverage Determinations (NCDs) + Familiarity with common commercial payer policies and reimbursement methodologies. + Coding Systems expertise in ICD-10 and HCPCS codes + Strong… more