- WMCHealth (Hawthorne, NY)
- …in compliance with detailed requirements, guidelines, and deadlines of Centers for Medicare & Medicaid Services, National Committee for Quality Assurance (NCQA) in ... Medical Staff Office by identifying, initiating, monitoring, and maintaining Medicaid and Medicare enrollment requirements. + Ensure proper attention is given to all… more
- National Health Care Associates (Melville, NY)
- …to personalized resident care plans and ensures the capture of clinical reimbursement for services provided. Fulltime; Monday - Friday** Weekly pay!** **Key ... prospective residents by assessing their nursing needs and determining appropriate clinical reimbursement levels + Complete and assure the accuracy of the MDS… more
- WMCHealth (Valhalla, NY)
- …payment of their medical treatment and to determine the method of payment/ reimbursement to Westchester Medical Center. This involves coordination with other Medical ... including Blue Cross/Blue Shield, Workers' Compensation, private insurance carriers, Medicare and Medicaid to verify the patient's eligibility for coverage,… more
- Albany Medical Center (Albany, NY)
- …selecting and sequencing the codes such that the organization receives the optimal reimbursement to which the facility is legally entitled, remembering that it is ... unethical and illegal to increase reimbursement by means that contradict requirements. Essential Duties and Responsibilities + Use a computerized encoding system to… more
- Calvary Hospital (Bronx, NY)
- …by Calvary Hospital. Interfaces with managed care organizations to facilitate reimbursement for services provided by the Hospital. Oversees the appeals process ... for those cases for which reimbursement has been denied. Conducts interdepartmental meetings related to the quality and utilization of clinical services. Serves on… more
- Kaleida Health (Buffalo, NY)
- …assumes the responsibilities as delegated by the Director of Clinical Reimbursement and Quality and/or the Administrator.This position also pro-actively provides ... reimbursement planning and is responsible for key decision-making related to Medicare , Medicaid, and other Third Party Payors to ensure payment. Provides… more
- Bassett Healthcare (Oneonta, NY)
- …of Advanced Beneficiary Notice signatures and form processing to meet Medicare regulations. Ensures all corrections (demographics, insurance eligibility etc) based ... is recorded in accordance with standard operating procedure to support reimbursement and regulatory compliance and patient care. When appropriate prior… more
- Grifols Shared Services North America, Inc (Albany, NY)
- …the business territory including major accounts and large players (ie, Commercial, Medicare , and Medicaid) *Understanding of Hospital formulary with guidance of RSD ... fulfill customer needs and impact pull-through (eg, MSL, IG Nurse Educator, reimbursement specialist) *Gather and provide customer insights to Marketing teams for… more
- FlexStaff (New York, NY)
- …extensive experience and strong technical knowledge of medical billing and insurance reimbursement processes to work for our external client, a world leading ... accurately submit claims to both private and public insurance carriers, including Medicare , Medicaid, and commercial plans. * Investigate and resolve denied or… more
- Humana (Albany, NY)
- …and as needed will communicates contract terms, payment structures, and reimbursement rates to providers. Maintains contracts and documentation within a tracking ... and communicating financial impact of contract terms, payment structures and reimbursement rates to providers. + Excellent written and verbal communication skills… more