- Guthrie (Corning, NY)
- …licensure/registration and standing, Queries the National Practitioner Data Bank and Medicare /Medicaid site for fraud and abuse and ECFMG verification, Sends ... special meetings and memos from the Staff, Maintains the permanent personnel and peer review files for all members of the Medical Staff in accordance with State code… more
- Calvary Hospital (Bronx, NY)
- …overall on-boarding process for patients admitted onto hospice program. + Review /verify admission information- data + Managers team for designated territories, ... of pre-admission documentation needs + Ensure visit schedule is generated + Review referral information; identify resources necessary for patient admission + Ensure… more
- Actalent (New York, NY)
- …to grow within managed care + Gain experience working with Medicare REQUIREMENTS: + California pharmacy technician license OR national pharmacy technician ... determination requests submitted from providers and determine if a pharmacist review is required + Obtain verbal authorizations and request detailed clinical… more
- CenterWell (Albany, NY)
- …services. Able to navigate healthcare options; care services post-acute offerings, Medicare coverage, billing issues, as well as accessing healthcare resources. + ... Health, Hospice, and Palliative Care Services. + Assist with clinical eligibility review for alternate services + Participates in special projects and performs other… more
- Insight Global (New York, NY)
- …specializes in health technology and provides remote patient monitoring to Medicare populations - specifically those with chronic illnesses (ex. Type2 diabetes, ... we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/ . Skills… more
- Northern Rivers Family Services (Albany, NY)
- …for which provide billable services or are required to register with Medicaid/ Medicare based on their credential, department and position. + Work with organizational ... CFO with weekly report of status of credentialing by program/provider for review with Chiefs. + Monitor license and credential expiration dates, provider electronic… more
- Northwell Health (Lake Success, NY)
- …of care provided. Responsible for concurrent inpatient medical record reviews for Medicare , Medicaid and all commercial payers. Generates queries and have follow up ... clinical documentation in the patient's medical record through a concurrent review process throughout the patient's inpatient stay. 4.Requests clarification of… more
- MVP Health Care (Tarrytown, NY)
- …the health care delivery system, including but not limited to Medicaid and Medicare benefits. + The overall objective is to create solutions to overcome barriers ... of quality, cost effective care. + The Case Manager will also monitor and review cases with the Medical Director to ensure appropriate outcomes. Other duties as… more
- Humana (Albany, NY)
- …meet required timelines. + Submits required documents to state agencies for review and approval. + Regularly meet with Humana Healthy Horizons Medicaid markets ... efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities at large. … more
- New York State Civil Service (Staten Island, NY)
- …program area.* Write responses to correspondence.* Resolve work problems.* Review forms and applications and make appropriate determinations.* Coordinate ... and maintain eligibility for full and unconditional participation in the Medicare and Medicaid programs. Continued employment will depend on maintaining… more