- WMCHealth (Valhalla, NY)
- …a positive, cheerful manner, promote our organization mission, vision and values. + Review daily IP, ER, Surgery and OP private pay admissions to determine ... complete continued education/trainingrequirements. Special Requirements: Knowledge of Medical Insurances ( Medicare , Commercial, HMO's, PPO's, etc.); EMTALA regulations, hospital billing… more
- City of New York (New York, NY)
- …Program, Management Benefits Fund, Employee Assistance Program, Work Well NYC, Medicare Part B Reimbursement and Pre-Tax Benefits & Citywide Programs including ... manner. 2. Prepares cost data and appropriate backup to supervisor and/or OMB for review within prescribed time limits. 3. Adheres to the methodology agreed to by… more
- Humana (Albany, NY)
- …objectives and approaches to assignments. + Reviewing staff monthly QA review variances + Daily inventory monitoring and assignment of escalated inventory ... efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities at large. … more
- WMCHealth (Valhalla, NY)
- …including Blue Cross/Blue Shield, Workers' Compensation, private insurance carriers, Medicare and Medicaid to verify the patient's eligibility for coverage, ... with the functions of hospital admitting, medical records and utilization review , particularly as they impact reimbursable costs; skill in making arithmetic… 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 as ... data to enhance decision-making and optimize reimbursement. . **Contract Review & Interpretation:** + Analyze and interpret contract terms, conditions,… more
- Robert Half Accountemps (Albany, NY)
- …representatives from commercial insurers and entitlement programs (eg, Medicaid/ Medicare ) to complete credentialing requirements. + Prepare credentialing packets, ... programs. + Provide weekly credentialing status reports to the CFO for executive review . + Monitor and track provider license and credential expiration dates; send… more
- MVP Health Care (Tarrytown, NY)
- …(EP), HARP, On-Exchange Qualified Health Plans (QHP), Off-Exchange Plans, and Medicare Advantage plans to individuals at Federally Qualified Health Centers (FQHCs), ... data in CRM (Dynamics 365) for assigned territories. + On a regular basis, review electronic applications in CRM (Dynamics 365) to ensure the integrity and quality… more
- Highmark Health (Albany, NY)
- …skills, as well as conceptual and analytic skills in order to review and articulate corporate objectives and regulations across all relevant audiences. + ... and cross-functional strategy development. + Experience with managed care, Medicare and federal and/or state regulations, quality improvement and compliance… more
- Owens & Minor (Kingston, NY)
- …and data to identify referral targets. + Partners with the Market VP to review sales territory call plan to achieve strategic goals. + Educates referral sources on ... the company to drive sales growth. + Communicate and clarify Medicare guidelines around private insurance procedures, pricing information, and product information… more
- Glengariff Rehabilitation and Healthcare Center (Glen Cove, NY)
- …Demonstrates an understanding of MDS requirements related to varied payers including Medicare , Managed Care and Medicaid + Ensures timely electronic submission of ... on a monthly basis + Responsible for timely and accurate completion of Utilization Review and Triple Check + Serves on, participates in, and attends various other… more