- Molina Healthcare (Buffalo, NY)
- …representatives in accordance with the standards and requirements established by the Centers for Medicare and Medicaid Services (CMS). M-F from 8am - 4:30pm EST ... coordination of benefits (COB), subrogation and eligibility criteria. * Experience with Medicaid and Medicare claims denials and appeals processing, and… more
- Molina Healthcare (Buffalo, NY)
- …Act** cases in accordance with the standards and requirements of Centers for Medicare and Medicaid Services (CMS). **Essential Job Duties** * Responsible for ... coordination of benefits (COB), subrogation and eligibility criteria. * Experience with Medicaid and Medicare claims denials and appeals processing, and… more
- Molina Healthcare (Rochester, NY)
- …in accordance with the standards and requirements established by the Centers for Medicare and Medicaid Services (CMS). **Essential Job Duties** * Manages team ... complicated claims, COB and DRG/RCC pricing). * Experience with Medicaid and Medicare claims denials and appeals processing, and knowledge of regulatory… more
- Humana (Albany, NY)
- …Finance + Accounting/Finance knowledge/experience + Advanced SQL or similar + Medicare / Medicaid experience + Data architecture/solution architecture experience + ... are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. … more
- WellLife Network (NY)
- …submit timely, and accurate claims to private and public insurance payers, including Medicare , Medicaid , and commercial plans. 2. Verify the accuracy and ... + Strong understanding of CPT, ICD-10, and HCPCS coding principles. + Knowledge of, HMO/PPO, Medicare , Medicaid , and other payer requirements and systems. more
- Humana (Albany, NY)
- …determine, and oversee execution of, numerous strategies required to ensure success for our Medicare Stars and Medicaid LOBs. The ideal candidate for this role ... are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. … more
- Humana (Albany, NY)
- …day to day flexibility in care manager's schedule. **Duties:** + Telephonically assess Medicare , Medicaid , and/or and Group Account members and create actionable ... are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. … more
- Cognizant (Albany, NY)
- …and member onboarding for individual, group, and government-sponsored health plans ( Medicare , Medicaid , ACA), ensuring compliance with CMS, ACA, and ... sales and enrollment processes for individual, group, and government-sponsored health plans ( Medicare , Medicaid , ACA). * Strong understanding of CMS, ACA, and… more
- Cognizant (Albany, NY)
- …and member onboarding for individual, group, and government-sponsored health plans ( Medicare , Medicaid , ACA), ensuring compliance with CMS, ACA, and ... sales and enrollment processes for individual, group, and government-sponsored health plans ( Medicare , Medicaid , ACA). . Strong understanding of CMS, ACA, and… more
- Humana (Albany, NY)
- …Coder + Demonstrate ability to problem-solve complex coding issues + Experience with Medicare and Medicaid coding guidelines + Strong data entry and attention ... are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. … more