- Cardinal Health (Albany, NY)
- …and keep updated on policy or procedural changes + Investigate and resolve patient/ physician inquiries and concerns in a timely manner + Enter detailed information ... a call center or customer service environment, preferred + Clear knowledge of Medicare , Medicaid & Commercial payer policies and guidelines for coverage, preferred +… more
- Molina Healthcare (NY)
- …and the site of service. This position will be supporting our Washington State Medicare plan. We are seeking a candidate with previous Case Management experience and ... proficient knowledge of MS Suite, organized and analytical thinking. Experience with Medicare /Medicaid, MS 365 and familiarity with claims is highly preferred. The… more
- Arnot Health (Elmira, NY)
- …Case Management practice. The Case Manager will work cooperatively with the Physician Advisor and Team. DUTIES AND RESPONSIBILITIES: ** 1. Determines medical ... of admission and stay in accordance with Interqual. ** 2. Prepares Medicare /Non Medicare hospital notices of noncoverage (HINN) when patient's level… more
- Adecco US, Inc. (New York, NY)
- …In this client-facing, remote-based role, you will work directly with physician offices and manufacturer partners to resolve reimbursement challenges and deliver ... fast-paced role that demands a strong understanding of medical reimbursement, Medicare and commercial payers, and buy-and-bill or specialty pharmacy distribution… more
- Adecco US, Inc. (Utica, NY)
- …but not limited to insurance verification, prior authorizations, and/or claim adjudication, physician 's office or clinics. * Must have Medicare and commercial ... readiness and adoption. 7. Serve as a subject matter expert on Medicare and commercial payer structures, translating complex benefit data into actionable insights… more
- Molina Healthcare (NY)
- …Opportunity for a Texas licensed RN to join Molina to work with our Medicare members in the San Antonio service delivery area; candidates should reside in Bexar ... will be given to those candidates with previous experience working with the Medicare population within a Managed Care Organization (MCO). Mileage is reimbursed as… more
- Catholic Health Services (Rockville Centre, NY)
- …hospitals, three nursing homes, a home health service, hospice and a network of physician practices across the island. At Catholic Health, our primary focus is the ... care analysis, home office cost reports, budget capital reports, and various Medicare / Medicare cost report schedules, working alongside Director and Staff.… more
- Molina Healthcare (Yonkers, NY)
- …performance is achieving desired results + Keep abreast of Medicaid and Medicare reforms and their impact on Molina Healthcare **Job Qualifications** **Required ... of related experience in healthcare + Demonstrated understanding of Medicaid and Medicare programs or other healthcare plans + Analytical work experience within the… more
- WMCHealth (Hawthorne, NY)
- …credentialing for the medical staff at Westchester Medical Center Advanced Physician Services. Primary responsibility of this position is ensuring that all ... in compliance with detailed requirements, guidelines, and deadlines of Centers for Medicare & Medicaid Services, National Committee for Quality Assurance (NCQA) in… more
- New York State Civil Service (Utica, NY)
- …patients, including comprehensive admission assessments, dispensing medication, providing physician -ordered medical treatment, transcribing orders, and collection of ... eligibility for full and unconditional participation in the Medicaid and Medicare programs. Failure to maintain licensure, certification and Medicaid/ Medicare … more