- Excellus BlueCross BlueShield (Rochester, NY)
- …and audits utilizing knowledge and experience of ICD-9-CM/ICD-10-CM coding, Medicare Advantage and Commercial Hierarchical Condition Category (HCC) coding, and ... Medicaid Clinical Risk Groups (CRGs) to ensure compliance . * Assist in developing, implementing, evaluating and updating desktop processes, policies and procedures… more
- Finger Lakes Health (Geneva, NY)
- …Are you a dedicated Registered Nurse with a passion for leadership, compliance , and delivering exceptional care? Do you thrive in a supportive environment ... role in ensuring our residents receive top-quality care. You will coordinate Medicare assessments, care planning, and reimbursement efforts in alignment with all… more
- Buffalo Hearing & Speech Center (Williamsville, NY)
- …and ensuring compliance with regulations for HIPAA, DOH, Medicaid, and Medicare + Being aware of emergency procedures and assisting with patient care during ... emergencies + Continuous learning and process improvement + May be trained to specialize in certain clinic functions such as handling patient calls for scheduling speech-language evaluations and therapy or other specialized areas. Skills: + Knowledge of… 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
- Mount Sinai Health System (New York, NY)
- …procurement of financial assistance for patients with government-sponsored health plans including Medicare , Medicaid and TriCare. Preferred: 3 years of health care ... for proper functionality to ensure coverage for specific medications. 18.Maintains compliance with all pertinent regulations and laws (HIPAA, Board of Pharmacy,… more
- University of Rochester (Rochester, NY)
- …and Division. - Documents treatment in patient's electronic medical record in compliance with Program, Department and Hospital regulations. - Attends clinic staff ... the ability to be independently paneled by major insurance companies including Medicare and Commercial insurers. The University of Rochester is committed to… more
- CDPHP (Albany, NY)
- …as assigned Qualifications: + 3 years managed care experience with commercial, Medicare and Medicaid lines of business and regulatory requirements + Associates ... Word, Excel, and PowerPoint + Understanding of legal and regulatory contract compliance and network adequacy requirements + Strong planning and workflow management… more
- Living Resources (Albany, NY)
- …as needed, and maintain familiarity with both internal and external requirements for compliance . + Participate in agency and program training as it relates to tasks ... program and necessary admission/discharge requirements + Knowledge of Medicaid, Medicare , SNAP and Social Security benefits and applications/certifications for each… 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