- Humana (Albany, NY)
- …clinical experience + Knowledge of the managed care industry including Medicare , Medicaid and/or Commercial products + Must be passionate about contributing ... + Medical utilization management experience + Working with health insurance organizations, hospitals and other healthcare providers, patient interaction, etc.… more
- CenterWell (Albany, NY)
- …+ Experience working in coding languages such as SAS and SQL + Prior Medicare Advantage or health insurance background + Additional skills developing reports and ... **Additional Information** + This role provides a unique opportunity to get hands on Medicare Advantage experience in a rapidly growing area outside of bid season +… more
- Molina Healthcare (Buffalo, NY)
- …Summary** Responsible for developing the plan and strategy for health insurance products that support Molina's successful business development and operational ... to completion. Plans and manages aspects of the organization's health insurance product development objectives and initiatives across platforms. Plans and directs… more
- Trinity Health (Latham, NY)
- …chaplain, transportation and more!) as well as provide our participants with their Medicare /Medicaid insurance coverage. Our team of Social Workers are supported ... by two Case Workers and play a crucial role in our unique model of care. As both the provider and insurer, we have the unique ability to assess participant needs, approve it and directly provide it. We coordinate care across settings-from home to ED/hospital,… more
- Project Renewal, Inc. (Bronx, NY)
- …Disability Level II; Public Assistance Level II; Veterans benefits; Medicaid; Medicare ; HMO insurance ). Active problem-prevention and problem-solving measures ... with residents and clinical team. + Responsible for assessing clients for all entitlements programs they may be eligible for + Assist clients in securing documents required for entitlements applications + Maintain an up-to-date resource manual on changes in… more
- Healthfirst (NY)
- …management tool, preferably SAP/APM + Having worked with external insurance vendors/agencies (NIPR, DFS, Background check vendors). **Preferred Qualifications:** + ... Active NY State Producer License. + Experience with CRM; Salesforce a plus. **Compliance & Regulatory Responsibilities:** Noted above **License/Certification:** N/A WE ARE AN EQUAL OPPORTUNITY EMPLOYER. Applicants and employees are considered for positions and… more
- Stony Brook University (Stony Brook, NY)
- …performing billing processes and troubleshooting billing questions according to NYS DOH, Medicare , Medicaid and patient insurance regulations. d. Monitors the ... bills (invoices). Ensures tests are ordered, performed, and billed per Medicare /OIG regulations. f. Audits all test credits performed in Specimen Receiving… more
- Mohawk Valley Health System (Utica, NY)
- …in order to promote financial stability within the Hospital. Experience in billing Medicare , Medicaid, Commercial Insurance , HMOs, and Worker's Comp/No Fault is ... a plus. Core Job Responsibilities + Promotes a professional working relationship with insurance companies. Knows each payor representative and uses them as a contact… more
- Option Care Health (New York, NY)
- …Understanding of billing and reimbursement procedures for medical offices and hospitals (Commercial Insurance , Medicare Part B & D, Fee for Service Medicaid, ... market data. Pay Range is $167,399.14-$278,983.55 **Benefits:** -Medical, Dental, & Vision Insurance -Paid Time off -Bonding Time Off -401K Retirement Savings Plan… more
- KPH Healthcare Services, Inc. (Camillus, NY)
- …growing revenue and building customer relationships + Knowledge of payer sources ( Medicare , Medicaid, private insurance ) and DME billing practices **Special ... Ensure sales compliance with industry regulations (eg, HIPAA, CMS guidelines, insurance requirements). + Conduct regular field visits, ride-alongs, and customer… more