- 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 and ... 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
- Guidehouse (New York, NY)
- …regarding compliance, and reimbursement under outpatient grouping systems such as Medicare OPPS and Medicaid or Commercial Insurance EAPG's. + Knowledge and ... various types of authoritative information. + Maintains current knowledge of Medicare , Medicaid , and other third-party payer billing compliance guidelines… more
- Mount Sinai Health System (New York, NY)
- …implementation and contract compliance related to Facility Contracts for all Commercial, Medicare Advantage and Medicaid Managed Care Plans. The team serves ... processes, and related regulations. ? Familiarity with contract terms, NYS regulations, claims processing, and healthcare reimbursement models. ? Experience in… more
- Stony Brook University (East Setauket, NY)
- …+ Experience with Inpatient and Outpatient billing requirements (UB-04/837i) and/or CMS Medicare and New York Medicaid reimbursement methodologies. + ... support day-to-day business functions including but not limited to: billing, claims analysis appeals, follow-up, financial assistance and customer service. **Duties… more
- University of Rochester (Rochester, NY)
- …account review/resolution and all audits + Coordinate responses and resolution to Medicaid and Medicare credit balances. + Request insurance adjustments or ... independent decisions as to the processes necessary to collect denied insurance claims , no response accounts, and will investigate resolving billing issues. Maintain… more
- WellLife Network (NY)
- …and accurate claims to private and public insurance payers, including Medicare , Medicaid , and commercial plans. 2. Verify the accuracy and appropriateness ... prior to claim submission. 3. Analyze denied or underpaid claims , identify root causes, and coordinate resolution with payers...ICD-10, and HCPCS coding principles. + Knowledge of, HMO/PPO, Medicare , Medicaid , and other payer requirements and… more
- YesCare Corp (Goshen, NY)
- …+ Strong knowledge of Coordination of Benefit (COB) provisions in commercial, Medicaid , or Medicare environments. + Proficient understanding of ICD-9, HCPCS, ... pay is $25.00 to $27.00/HR based on experience** **Key Responsibilities** + ** Medicaid Eligibility & Coverage Coordination:** + Submit inmate applications to … more
- Cardinal Health (Albany, NY)
- …done. **The Accounts Receivable Specialist II is responsible for processing insurance claims and billing. They will work within the scope of responsibilities as ... and support from AR & Billing leadership teams.** **_Responsibilities_** + Processes claims : investigates insurance claims ; and properly resolves by follow-up &… more
- The Wesley Community (Saratoga Springs, NY)
- …team members to resolve billing-related concerns. + Ensure compliance with Medicare / Medicaid billing requirements, regulatory standards, and facility specific ... types. + Monitor and maintain aging reports for outstanding claims . Respond to and resolve insurance claims ...years of billing procedures for all payer types including Medicare , NY Medicaid , HMO and Private insurance… more
- Mount Sinai Health System (New York, NY)
- …implementation and contract compliance related to Facility Contracts for all Commercial, Medicare Advantage and Medicaid Managed Care Plans. The team serves ... MSHS Health System. This individual will ensure the accuracy of contract terms, reimbursement structures, and facilitate the flow of contract data into the revenue… more