- Datavant (Albany, NY)
- …work environment. + Keep up to date with current coding policies for ICD-10, Medicare Advantage, HHS (ACA), and other markets. + Provide guidance and make strategic ... or inpatient setting. + Current CCS, CRC, or CPC required. + Previous Medicare Advantage Risk Adjustment, CDI, Medicaid, Commercial RA, and HEDIS experience. +… more
- WMCHealth (Valhalla, NY)
- …party billing companies, Medicare and Medicaid, as well as insurance denial review as appropriate. + Ability to multi-task in a fast and high pressure ... Facility Billing, Insurance Verifications, Third Party Insurance coverage, Medicaid and Medicare eligibility, Insurance denial review and overturn procedures. +… more
- Stony Brook University (Stony Brook, NY)
- …Revenue Cycle Management is responsible for the development, implementation, maintenance, review and audit of the Hospital Charge Description Master to optimize ... charge capture audits utilizing both software tools and/or EMR and documentation review . May assist in the resolution of pre-billing charging issues and post-payment… more
- Mohawk Valley Health System (Utica, NY)
- …barriers to patient discharge. The Physician Advisor (PA) conducts clinical review of cases to ensure compliance with regulatory requirements, hospitals objectives, ... appropriateness of admission and continued stay, severity, and morbidity/mortality. + Review patient status when admission criteria is non-sufficient for admission.… more
- Otsuka America Pharmaceutical Inc. (Albany, NY)
- …territory plans through partnerships with internal and external stakeholders + Review and educate offices on payer policies, including prior authorization ... in rare disease + Strong knowledge of Centers for Medicare & Medicaid Services (CMS) policies and processes, especially... & Medicaid Services (CMS) policies and processes, especially Medicare Part D + Experience in "Buy and Bill"… more
- Arnot Health (Elmira, NY)
- …for outpatient medical oncology services in a timely and accurate manner + Review appointment schedules daily to confirm all procedures have insurance approval + ... carriers + Apply knowledge of CPT, ICD-9, HCPCS codes, and Medicare requirements to ensure maximum allowable reimbursement + Resolve pre-authorization issues… more
- Option Care Health (New Rochelle, NY)
- …is maintained by providing direct patient care 20-40% of the time. In a Medicare Certified Home Health agency, this position may also serve as the alternate ... Director of Nursing of the Home Health Agency for Medicare certified home health agencies in the absence of...using find and replace, undo, spell check, track changes, review pane and/or print functions). + Basic level skill… more
- Mount Sinai Health System (New York, NY)
- …registered; Completes the central log assuring all fields are complete 5. Completes Medicare Payor Questionnaire for all Medicare patients 6. Collects visit fees ... portion of the chart 16. Gives attending physician walk out charts for review twice daily **About Us** **Strength through Unity and Inclusion** The Mount Sinai… more
- New York State Civil Service (Bronx, NY)
- …may include, but are not limited to:* Interview clients and review medical/psychiatric history, and complete various assessments as part of treatment ... eligibility for full and unconditional participation in the Medicaid and Medicare programs. Failure to maintain Medicaid/ Medicare eligibility will result… more
- Cardinal Health (Albany, NY)
- …a call center or customer service environment, preferred + Clear knowledge of Medicare , Medicaid & Commercial payer policies and guidelines for coverage, preferred + ... Knowledge of Diagnostic Medical Expense and Medicare Administrative Contractor practices, preferred + Clear understanding of...other status protected by federal, state or local law._ _To read and review this privacy notice click_ here… more