- Anthony Jordan Health Corp (Rochester, NY)
- CHW/PATIENT CONNECTION SPECIALIST ROCHESTER, NY (http://maps.google.com/maps?q=82+Holland+St+ROCHESTER+NY+USA+14605) * PPC Apply Job Type Full-time Description The ... and documentation skills. . This position requires some expertise in Medicaid, Medicare , and ADAP insurance programs. . Sensitive to confidential information and… more
- Molina Healthcare (Yonkers, NY)
- …surveys and federal/state QI compliance activities. **KNOWLEDGE/SKILLS/ABILITIES** The Specialist , Quality Interventions/ QI Compliance contributes to one or ... Health or Healthcare. **Preferred Experience** 1 year of experience in Medicare and in Medicaid. **Preferred License, Certification, Association** + Certified… more
- WMCHealth (Valhalla, NY)
- Financial Reimbursement Specialist - On Site Company: NorthEast Provider Solutions Inc. City/State: Valhalla, NY Category: Finance/Info Systems Department: Revenue ... surveys and reports to external agencies. + Gathers data in preparation of Annual Medicare & Medicaid Cost Reports. + Aid in the preparation of the hospital's annual… more
- Molina Healthcare (NY)
- …to determine if providers have sanctions/exclusions. * Reviews and processes daily alerts for Medicare Opt-Out reports to determine if any provider has opted out of ... Medicare . * Reviews and processes daily NPDB Continuous Query reports and takes appropriate action when new reports are found. **JOB QUALIFICATIONS** **Required… more
- Molina Healthcare (Rochester, NY)
- …in accordance with the standards and requirements established by the Centers for Medicare and Medicaid Services (CMS). **Essential Job Duties** * Enters denials and ... * Customer/provider experience in a managed care organization (Medicaid, Medicare , Marketplace and/or other government-sponsored program), or medical office/hospital… more
- Molina Healthcare (Syracuse, NY)
- …with the standards and requirements established by the Centers for Medicare and Medicaid **KNOWLEDGE/SKILLS/ABILITIES** + Responsible for the comprehensive research ... benefits, subrogation, and eligibility criteria. + Familiarity with Medicaid and Medicare claims denials and appeals processing, and knowledge of regulatory… more
- YAI (Manhattan, NY)
- …and entitlements in the healthcare and/or I/DD field including Medicaid, Medicare and applicable regulatory agencies. + Strong written and oral communication ... skills, including the ability to effectively obtain and communicate information with staff at varying levels. + Detail oriented and highly organized with good time management and follow-up skills, including the ability to effectively track and accurately… more
- Molina Healthcare (Yonkers, NY)
- …tools such as Department of Health and Human Services (DSHS) and Medicare billing guidelines, Molina claims processing policies and procedures, and other resources ... to validate overpayments made to providers. * Completes basic validation prior to offset to include, eligibility, coordination of benefits (COB), standard of care (SOC) and diagnosis-related group (DRG) requests. * Enters and updates recovery applications and… more
- City of New York (New York, NY)
- …Program, Management Benefits Fund, Employee Assistance Program, Work Well NYC, Medicare Part B Reimbursement Program and Pre-Tax Benefits & Citywide Programs, ... including the Deferred Compensation Plan and NYCE IRA. In addition to negotiating collective bargaining agreements, OLR serves as a resource to agencies with regard to workforce labor issues and works with the Municipal Labor Committee (MLC) to pursue… more
- Mount Sinai Health System (Elmhurst, NY)
- …assists with the Medicaid enrollment and maintains files . 2. Assist with Medicare enrollment and maintenance file requests. 3. Submits updated licenses and deas as ... requested by payor. 4. Maintains and updates One App Pro with physician information. 5. Maintains and updates CAQH for all FPG providers. 6. Maintains inventory file and pulls requested signature pages. 7. Assist with clean up of Charge Review workqueues as… more