- The Institute for Family Health (New Paltz, NY)
- …Article 31, and Dental Rules and Regulations around the Medicaid and Medicare RESPONSIBILITIES: + Compile and maintain records, statistics and reports as necessary. ... new staff + Coordinate new hire initial training, shadowing, and evaluation + Review and distribute correspondence and follow up as needed + Monitor current status… more
- Mount Sinai Health System (New York, NY)
- …equivalent credential required + Proficient in CPT, HCPCS, revenue codes, and Medicare billing regulations. + Advanced proficiency in Epic, especially in EAP ... Mount Sinai Hospital **Responsibilities** **New Charge Requests & Clinical Documentation Review :** + Review clinical documentation to validate appropriate charge… more
- Access: Supports For Living (Middletown, NY)
- …and insurance companies, including but not limited to daily procedure review , self-pay and co-payment processing, ensuring payments related to participant services ... of identified revenue cycle billing issues + Handling billing cycle review procedures for pre-processing (scrubbing) of weekly claims processing + Analyze,… more
- Bassett Healthcare (Cooperstown, NY)
- …of care (LOC) and hospital protocols to make recommendations for unit placement Review traditional Medicare fee for service (FFS) using the two-midnight rule ... liaison between emergency services, surgical services, nursing, finance, physicians, utilization review and medical records to ensure appropriate bed is assigned,… more
- HCR Home Care (Rochester, NY)
- …as resource for problem-solving or advising on patient care questions or concerns. + Review and approve all new interim orders before they are sent to physician. ... intervention and g oals for d ocumentation to include vital sign alert . + Review missed visit reports, ensure MD notification has occurred and , if not, notify MD.… more
- Stony Brook University (Commack, NY)
- …by the MCO within timeframes required by MCO. + Gather and review data for reporting purposes to meet MCE delegated credentialing contractual obligations. ... notice from the MCO, furnish the report or roster review within the timeframe required by delegated credentialing agreement....or payer. + Direct experience with NYS Medicaid and Medicare enrollment and recertification. + Experience setting up and… more
- Trinity Health (Albany, NY)
- …documentation improvement specialist with a solid background in value-based plans (VBP), Medicare Advantage (MA) and Medicare shared savings program (MSSP) as ... the overall quality, accuracy and integrity of documentation through extensive record review , reporting, trending and education. + Serves as a resource for… more
- New York State Civil Service (Orangeburg, NY)
- …physical ability, and/or rehabilitative and clinical needs of individuals. * Review and evaluate program effectiveness and recommending program changes or ... specialized activities as needed.* Attend and participate in treatment plan review sessions providing input as relates to the program participants participation in… more
- Molina Healthcare (Yonkers, NY)
- …administration of contracts with State and/or Federal governments for Medicaid, Medicare , Marketplace, and other government-sponsored programs to provide health care ... of deliverables/submission between staff and governmental agencies and contract review . * Maintains calendar and databases documenting regulatory filings, approvals… more
- WMCHealth (Valhalla, NY)
- …requests for specialty medications, tracking expiring authorizations and renewals + Review claims and rejections to determine required follow-up, ensuring timely ... & Quality Assurance: + Ensure all activities are compliant with HIPAA, Medicare /Medicaid billing regulations, and the 340B Drug Pricing Program + Participate in… more