- Humana (Albany, NY)
- …hours** **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other ... Utilization management experience in a medical management review organization, such as Medicare Advantage, Managed Medicaid , or Commercial health insurance. +… more
- University of Rochester (Brighton, NY)
- …+ Self-Referral Law, the False Claims Act, Civil Monetary Penalties, and + Medicare and Medicaid billing regulations (including CMS, Medicare Advantage ... relevant reimbursement and billing issues and requirements (including CMS, Medicare Advantage, and New York State Medicaid )....CMS, Medicare Advantage, and New York State Medicaid ). Stays abreast of Medicare and … more
- Excellus BlueCross BlueShield (Rochester, NY)
- …BlueShield Association, the Food and Drug Administration (FDA), and Centers for Medicare and Medicaid Services (CMS). Provides routine interaction and ... + Maintains accurate and up-to-date knowledge of all Government Programs regulations ( Medicaid , Medicare , Federal Employee Program, New York State Department 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. ... Responsible for end to end market support for assigned Medicaid markets to ensure markets achieve their VBP contract...changes to existing VBP models + Coordinate internally with Medicaid VBP model design, contracting, and operations and analytics… more
- New York State Civil Service (Buffalo, NY)
- …Medical Specialist 2; ANDEligibility for full and unconditional participation in the Medicaid and Medicare programs.OROpen Competitive:Possession of a license to ... a medical specialty; AND Eligibility for full and unconditional participation in the Medicaid and Medicare programs. OR Provisional Opportunity - Possession of a… more
- New York State Civil Service (East Syracuse, NY)
- …the SCR may be barred from appointment.You are responsible for payment of all required fees. Medicaid and Medicare : In order to be eligible for appointment and to ... excluded individual or entity on any of the Federal and/or State Medicaid and Medicare exclusion lists (or excluded from any other Federal or Federally assisted… more
- Mount Sinai Health System (Astoria, NY)
- …knowledge preferred. + **Experience:** Two years minimum of healthcare experience including Medicare or Medicaid Provider or Facility Enrollment or Credentialing ... Mount Sinai Queens **Responsibilities** + Ensure enrollments for new providers in Medicaid , Medicare , Managed Care plans, Commercial Health plans and Exchange… more
- Guidehouse (New York, NY)
- …various types of authoritative information. + Maintains current knowledge of Medicare , Medicaid , and other third-party payer billing compliance guidelines ... on provider/clinical documentation. + Knowledge, understanding and proper application of Medicare , Medicaid , and third-party payer UB-04 billing and reporting… more
- Catholic Health (Buffalo, NY)
- …is responsible for the coordination, preparation, and timely filing of the various Medicare , Medicaid , Champus cost reports, surveys, rate reviews, filing of ... as well as newly identified initiatives. The position coordinates audits related to Medicare (cost report, wage index, etc.) and Medicaid . The position… more
- University of Rochester (Rochester, NY)
- …create barriers to access for patients. Remains knowledgeable of private payer, Medicare , and Medicaid structure systems and reimbursement processes. Respond to ... individual providers, as well as University of Rochester groups, with Medicare and Medicaid as required each cycle. + Completes new enrollments of APP's… more