- Humana (Albany, NY)
- …on Pricer edit resolution + Provide consultation to internal business partners on Medicare reimbursement/ editing logic and Humana system logic **Use your skills ... closely with IT, the pricing software vendor, CIS BSS, claims operations, and other business teams involved in the...to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel,… more
- Northwell Health (Lake Success, NY)
- …and billing modules. + Understanding of payer guidelines and regulations (eg, Medicare , Medicaid , commercial payers). + Exceptional attention to detail and ... of project plans and evaluates outcomes. This role is instrumental in ensuring claims are accurately prepared and edited within Epic before submission to payers,… more
- Humana (Albany, NY)
- …Disputes team reviews and educates providers when there is a dispute on adjudicated claims that contain a code editing related denial or financial recovery. The ... Demonstrate ability to problem-solve complex coding issues + Experience with Medicare and Medicaid coding guidelines + Strong data entry and attention to detail… 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. ... certification from the AAPC and/or AHIMA) + Extensive knowledge of medical claims processing and familiarity with reimbursement methodologies, ICD, CPT, and HCPCS +… more