- Mount Sinai Health System (New York, NY)
- …knowledge of a health care EMR such as Epic/Clarity, aCW, etc.; a payor claims system such as Facets, Amisys, etc.; or a hospital/provider system such as IDX, ... or medical economics departments highly valuable. + Experience as a nurse informaticist highly valuable. + Experience working in healthcare provider analytics… more
- Constructive Partnerships Unlimited (Staten Island, NY)
- …meetings and as needed with all shifts of Direct Care Counselors, Nurse , and Clinical Team. 5. Responsible for scheduling all annual medication re-certifications ... with the Nurse Case Managers or designated RN's and ensuring documentation...code of business conduct, the NYS and federal false claims acts, whistleblower protections and mandatory reporting. Completes corporate… more
- Public Consulting Group (Albany, NY)
- …Third Party Administrator Services + Enhance Health and Public Safety Services + Claims Processing Services and Solutions + Consulting and Advisory Services + Cost ... Proven working experience in case management, including as a nurse , medical, mental health care manager or a related...+ Current license, certification or registration as a Registered Nurse or Social Worker **Working Conditions** + Office Setting… more
- Veterans Affairs, Veterans Health Administration (Castle Point, NY)
- …the Medicare Rate. This position includes payment reconciling for Community Care medical claims submitted for payment due to outsourcing of treatment for VA Hudson ... of medical clinicians across multiple disciplines (eg medical doctors, nurse practitioners, physician assistants, psychologists, psychiatrists, social workers, clinical… more
- Community Medical and Dental Care Inc (Monsey, NY)
- …Medical and Dental Care, is seeking an experienced Family, Pediatric, or Specialty, Nurse Practitioner. for a full-time or part-time position. We offer a very ... of all professional services rendered. + Prepare and review reports, claims , and correspondence; ensure that records and documentation are compliant with… more
- OLV Human Services (Tonawanda, NY)
- …that the EPS (as applicable) and DSPs remain competent in all Nurse Delegated Duties. 15. Communicates with parents/guardians/advocates as needed, regarding the ... all federal and state regulations and agency policies pertaining to HIPAA, false claims , whistleblower policies and all others. 25. Performs other duties and assumes… more
- Trinity Health (Albany, NY)
- …assignments. **What you will need:** + A current license to practice as a Practical Nurse in the State of New York + Graduate of accredited school of Practical ... and practice workflows: + Scheduling and registration + Check-in + Check-out + Charge entry/ claims + End of day processes + General duties including but not limited… more
- BronxCare Health System (Bronx, NY)
- …collection, analysis, implementation of and compliance with risk management and claims activities, support of and participation in Continuous Quality Improvement ... of supplies. k) Reports changes in patient's conditions to the Registered Nurse . l) Prepares patient for examination and assists provider during examination. m)… more
- Highmark Health (Buffalo, NY)
- …gain/risk share contract parameters. This includes analysis and interpretation of claims submission for superior coding accuracy, cost and utilization reports, ... strategies to meet market needs **LICENSES/CERTIFICATIONS** **Required** + Registered Nurse **Preferred** + None **Language (Other than English):** None **Travel… more
- Excellus BlueCross BlueShield (Buffalo, NY)
- …timely manner and provides support for the Case Management (CM) and Registered Nurse (RN) reviewers and manages the denial process. + Leads interdisciplinary complex ... and foster care system. + Develops, conducts concurrent and retrospective reviews of claims and appeals and resolves grievances related to medical quality of care,… more