- Molina Healthcare (Albany, NY)
- …ensure compliance with the National Committee for Quality Assurance (NCQA), Centers for Medicare and Medicaid Services (CMS), state Medicaid entity ... delegated groups. + Assists in preparation of documents for Centers for Medicare and Medicaid Services (CMS), state Medicaid , National Committee for Quality… more
- KPH Healthcare Services, Inc. (Gouverneur, NY)
- …employees. **Job Summary:** Assist in billing and cash application of Medicaid / Medicare /DME/Home Infusion claims. Manage open accounts receivable which requires ... for customers with denied charges. + Assist in the rebilling of Medicaid / Medicare , Aristacare, and Kinney Homecare claims. + Interact with KPH Employees (Store… 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. ... of SQL experience, preferably in SSMS. **Preferred Qualifications** + Medicare Advantage experience. + Experience with SQL and VBA...role is part of a team that owns the Medicare Advantage pricing methodology and supporting tools in the… 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. ... expert on the End Stage Renal Disease (ESRD) population for Humana's individual Medicare Advantage plans. This includes: + Owning and improving our ESRD claims… 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. ... This role will support a few tools used within our Individual Medicare Advantage pricing and internal reporting process. This includes: + Helping make… 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. ... coding languages such as SAS and SQL + Prior Medicare Advantage or health insurance background + Additional skills...role provides a unique opportunity to get hands on Medicare Advantage experience in a rapidly growing area outside… 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
- Health Advocates Network (Albany, NY)
- …This division serves as the liaison to the Governor's office, Centers for Medicare and Medicaid Services, and other state-agencies. Position Description: The ... a wide range of services and programs for children provided under the Medicaid program including the Children's Health Home program, the voluntary foster care… more
- Health Advocates Network (Albany, NY)
- …This division serves as the liaison to the Governor's office, Centers for Medicare and Medicaid Services, and other state-agencies. Position Description: The ... a wide range of services and programs for children provided under the Medicaid program including the Children's Health Home program, the voluntary foster care… more
- New York State Civil Service (Albany, NY)
- …eligible and maintain eligibility for full and unconditional participation in the Medicare and Medicaid programs. Continued employment will depend on maintaining ... and actionable data. Data sources may include, but are not limited to, Medicaid data, enrollment data, case management records, survey data, and data from other… more