- Molina Healthcare (Buffalo, NY)
- …Company's assigned contact to log tickets for premium restoration such as Medicare Secondary Payer and ESRD. **JOB QUALIFICATIONS** **Required Education** HS Diploma ... or GED **Required Experience** 1-3 years' experience in an administrative support. **Preferred Education** Associate degree **Preferred Experience** 3+ years' experience in an administrative support role. To all current Molina employees: If you are interested… more
- Elevance Health (East Syracuse, NY)
- … of complex exception requests and CMS change requests. + Perform supervisory review of workload involving complex areas of Medicare part A reimbursement ... Health's family of brands. We administer government contracts for Medicare and partner with the Centers for Medicare...experienced associates as assigned. + Prepare and perform supervisory review of cost report desk reviews and audits. +… more
- Humana (Albany, NY)
- …help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing home health, SNF, DME, dual Medicare ... of services provided by other healthcare professionals in compliance with review policies, procedures, and performance standards. All work occurs with a… more
- Humana (Albany, NY)
- …help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing home health, SNF, DME, dual Medicare ... of services provided by other healthcare professionals in compliance with review policies, procedures, and performance standards. All work occurs with a… more
- Charles Evans Center (Bethpage, NY)
- …front desk supervisor on billing issues + Monitor provider credentialing with Medicaid, Medicare , and commercial plans + Assist with review and negotiation of ... + Resolve claim denials and outstanding A/R to support timely collections + Review and update billing policies and procedures for efficiency and compliance + Ensure… more
- Actalent (Syracuse, NY)
- …Responsibilities + Review clinical trial protocols and budgets to determine Medicare coverage. + Analyze billing details to ensure compliance with federal rules. ... Medicare Coverage Analyst - MUST RESIDE IN NY Job Description The Medicare Coverage Analyst is responsible for reviewing clinical trial protocols and budgets to… more
- Humana (Albany, NY)
- …and other vendors. + Document all calls and requests. + Search for Medicare and Medicaid Guidelines. + Process all incoming fax/emails request for services the ... and/or ICD-10 codes. + Member service + Experience with Utilization Review and/or Prior Authorization, preferably within a managed care organization. **Additional… more
- New York State Civil Service (East Syracuse, NY)
- …Credentials will be reviewed at the time of interview.Background Investigation/Justice Center Review : In some agencies, the names of all prospective employees will* ... are responsible for payment of all required fees.Medicaid and Medicare : In order to be eligible for appointment and...on any of the Federal and/or State Medicaid and Medicare exclusion lists (or excluded from any other Federal… more
- New York State Civil Service (NY)
- …and procedures when needed to ensure the provision of quality care. * Review of lab work, specialty consults, hospital discharges, medical visit summaries and ... the group home, the hospital, the rehabilitation setting and/or community providers.* Review and approval of discharge summaries prior to accepting an individual… more
- New York State Civil Service (Schenectady, NY)
- …Street in Schuylerville. Duties would include but not be limited to review and establish medical histories, perform physical examinations, and manage the medical ... nutrition services to develop individualized therapy plans as necessary.* Review discharge plans from hospitalizations to resume care in...on any of the Federal and/or State Medicaid and Medicare exclusion lists (or excluded from any other Federal… more