- Arnot Health (Bath, NY)
- …the Long Term Care staff, attends weekly care conference meetings, and weekly Medicare A review with care team and therapies. + Demonstrates effective time ... management, flexibility and priority setting. + Promotes and ensures the delivery of quality resident care through competency based assignments and supervision of staff. + Supports the philosophy and objectives of the Long Term Care Department. + Ensures the… more
- Healthfirst (NY)
- …visualization tools like Tableau and Knowledge of NY lines of business such as Medicare NY, Medicaid, Child Health Plus, QHP, EP, HARP + Bachelor's degree in ... Accounting, Finance, or Business Administration from an accredited institution preferred. + Certification in claims processing or related area (eg, CPC, AIC) WE ARE AN EQUAL OPPORTUNITY EMPLOYER. Applicants and employees are considered for positions and are… more
- Humana (Albany, NY)
- …and other vendors. + Document all calls and requests. + Search for Medicare and Medicaid Guidelines. + Process all incoming fax/emails request for services the ... in special projects as assigned by your Supervisor or Manager . **Use your skills to make an impact** **Required...recognized leader in healthcare delivery that has been offering Medicare Advantage health plans in Florida over 23 years.… more
- University of Rochester (Rochester, NY)
- …on assigned tasks, following standard procedures, and as directed by the Manager , Billing or Manager . Independent judgement is necessary in escalating ... of credits - - Review and advise supervisor or manager on trends of incorrectly paid claims from specific...reports:- - - 2nd insurance level report - - Medicare and Medicaid credit balance report - - Over… more
- SUNY Upstate Medical University (Syracuse, NY)
- …to patient care problems. In conjunction with Medical Director and Practice Manager interviews clinical staff and has input into new hires. Orients, trains, ... evaluates (in conjunction with Practice Manager and/or Medical Director) all clinical staff in the...consistent with practice). Must have NPI number and be Medicare Enrolled with Medicare Identification Number (or… more
- SUNY Upstate Medical University (Syracuse, NY)
- …to patient care problems. In conjunction with Medical Director and Practice Manager interviews clinical staff and has input into new hires. Orients, trains, ... evaluates (in conjunction with Practice Manager and/or Medical Director) all clinical staff in the...consistent with practice). Must have NPI number and be Medicare Enrolled with Medicare Identification Number (or… more
- University of Rochester (Rochester, NY)
- …and adjudication, including refund of credits + Review and advise supervisor or manager on trends of incorrectly paid claims from specific payers + Work with ... supervisor/ manager on communication to payer representatives regarding payment trends...trends that requirement management intervention; assist management team with Medicare and Medicaid credit balance audits, and third-party payer… more
- Ellis Medicine (Schenectady, NY)
- …team updated on progress or changes in the discharge plan. + Assists Case Manager with medication prior authorizations. + Provides Medicare Important Message to ... is to work with the Social Worker, Nurse Case Manager , or Utilization Management Nurse to facilitate patient discharge...make post discharge arrangements for patients. + Assists Case Manager or Social Worker by offering choice of providers.… more
- Independent Health (Buffalo, NY)
- …Independent Health policies, summary plan descriptions, member contracts, and Centers for Medicare and Medicaid Services (CMS) guidelines for all lines of business. ... managers, attorneys, other insurance companies, regulatory agencies (ie Centers of Medicare and Medicaid) and internal departments effectively. + Identify and… more
- Healthfirst (NY)
- …Responsible for entering, maintaining, and monitoring identified projects in Logic Manager and coordinates within Regulatory Affairs team. + Communicates and ... Provides support to all internal stakeholders during the annual Medicare Go to Market project in preparation for the... Go to Market project in preparation for the Medicare Annual Enrollment Period (AEP). + Contributes to the… more