- University of Rochester (Rochester, NY)
- …audits, and third-party payer audits. + Coordinate responses and resolution to Medicaid and Medicare credit balances- - - Review all accounts on the Medicaid and ... final resolution and adjudication, including refund of credits + Review and advise supervisor or manager on trends of...the account to a self-pay financial class after a review of previous efforts has not resulted in revenue… more
- Stony Brook University (Stony Brook, NY)
- …Assistant** **may include the following but are not limited to:** + Billing for Medicare (Part A & B), Medicaid, Private, Insurance, NAMI, Physician, and Adult Day ... the Attorney General's office. + Monitor all Medicaid remittances, review any case denied, and rebill if necessary or...system and monthly closing functions. + Enroll residents in Medicare Part D plans. + Oversee all banking for… more
- Bassett Healthcare (Cooperstown, NY)
- …of Advanced Beneficiary Notice signatures and form processing to meet Medicare regulations. Ensures all corrections (demographics, insurance eligibility etc. based ... from providers or other staff to adjust appointment schedules to Supervisor for review and approval before acting, as noted by Supervisor. Reviews the electronic… more
- New York State Civil Service (Syracuse, NY)
- …or family therapy; crisis intervention, consultation to other agencies; training and peer review .In addition to the above duties, you may also perform the following ... or release to strict and intensive community supervision and treatment; develop, review , and oversee behavior management plans and/or treatment plans; and develop… more
- New York State Civil Service (Brooklyn, NY)
- …would be responsible for the provision of pharmaceutical care, including the review , dispensing and monitoring of inpatient and outpatient medications. You would ... on any of the Federal and/or State Medicaid and Medicare exclusion lists (or excluded from any other Federal...appointed you may be required to become an enrolled Medicare provider; obtain and provide to your employer a… more
- New York State Civil Service (Syracuse, NY)
- …and refer individuals for admission, transfer, discharge, and further treatment* Review and maintain medical records and documentation consistent with facility, ... on any of the Federal and/or State Medicaid and Medicare exclusion lists (or excluded from any other Federal...appointed you may be required to become an enrolled Medicare provider; obtain and provide to your employer a… more
- Northwell Health (Westbury, NY)
- …Federal and State regulations. + Applies coding rules and regulations to the validation review process. + Reviews codes on Medicare /non- Medicare charts for ... the documentation in the Medical Record. Job Responsibility + Audits and reviews Medicare /non- Medicare charts to ensure that proper standards are maintained in… more
- Stony Brook University (Stony Brook, NY)
- …may include the following but are not limited to:** + Completes Utilization review screen for inpatient and observation cases. Activity includes UR from the ... cases for authorization for in patient stay. + Staff review short stay, long stay and complex cases to...Documents over utilization of resources and services. + All Medicare cases are reviewed for level of care on… more
- Intermountain Health (Albany, NY)
- …Integrity (CDI) Registered Nurses (RN) and Intermountain Physician Advisors to review complex facility encounters and assign International Classification of Diseases ... optimization of reviews while patients are hospitalized. It aids in the review of quality measures including Patient Safety Indicators and Hospital Acquired… more
- Molina Healthcare (Albany, NY)
- …medical director, and quality improvement staff. + Facilitates conformance to Medicare , Medicaid, NCQA and other regulatory requirements. + Reviews quality referred ... requests in timely support of nurse reviewers; reviews cases requiring concurrent review , and manages the denial process. + Monitors appropriate care and services… more