- Sumitomo Pharma (Albany, NY)
- **Title: Sr. Manager , Medicaid Contract Administration** **Location: Remote/occasional onsite (if local to MA). Flexible work/life balance.** Sumitomo Pharma ... motivated, and experienced individual for the position of **Sr. Manager , Medicaid Contract Administration.** The Sr. ...of the life science industry specific to the Medicaid payer landscape. The decisions made in this position affect… more
- Ellis Medicine (Schenectady, NY)
- …and payers are in agreement for appropriate claims reimbursed. * Attend monthly payer meetings to continuously improve communications between provider and payer ... Track all registration errors and report error to the manager as necessary for interdepartmental communication. Log and forward...then claims will be submitted daily to the appropriate payer as indicated. * Notify the supervisor when a… more
- Albany Medical Center (Albany, NY)
- …are prepared to reimburse for scheduled services in accordance with the payer -provider contract and works diligently toward the identification, mitigation, and ... Representatives and other Authorization Specialists with patient clinical questions, payer escalation and triaging patient calls accordingly. Will work… more
- HealthEdge Software Inc (Albany, NY)
- …door to new value-based reimbursement models, benefits plans and provider contracts . The complete suite of solutions fromHealthEdgedelivers a digital foundation for ... payers specifically designed to fuel a digital transformation, reduce costs, and improve both clinical outcomes and the member experience. **Your impact** **:** + Manage and standardize programs to meet the client's release/deployment and quality criteria. +… more
- CVS Health (Albany, NY)
- …but help them stay well in body, mind and spirit. The 340B Account Manager is responsible for growing customer Contract Pharmacy and retail pharmacy business ... attainment and patient participation for contracted business arrangements with clients, payer organizations and retail pharmacies. This position will require travel… more
- HealthEdge Software Inc (Albany, NY)
- …to grow with their organization over time-bringing disparate parts of a payer 's organization together for improved accuracy and insights. The Source platform offers ... Transformation features Medicare and Medicaid content coupled with flexible contract configuration capabilities for Commercial lines of business. Payment Integrity… more
- Albany Medical Center (Albany, NY)
- …required + Computer skills (High proficiency) + Insurance knowledge regarding payer contract interpretation including Authorization Requirements and Setting of ... be able to work in conjunction with Nursing Supervision and Patient Triage Manager for accurate bed assignment for inpatient and observation patients. In addition,… more
- CenterWell (Albany, NY)
- …support accreditation requirements + Oversight of home infusion reporting for third party payer contracts + Monitor the following key functions: + Program ... vendors and as necessary + Reviews and updates vendor contracts with procurement as necessary + Ensure that the...of home health services, and fourth largest pharmacy benefit manager , CenterWell is focused on whole-person health by addressing… more
- Trinity Health (Albany, NY)
- …receive. Performs insurance eligibility/benefit verification, utilizing EDI transactions and payer web access, and calls payers directly. Documents information ... support progressive responsibility. Other duties as needed and assigned by the manager . Maintains a working knowledge of applicable Federal, State and local… more
- Evolent Health (Albany, NY)
- …to assigned health plan. + Acts as Subject Matter Expert on the contract for their assigned health plan, particularly billing requirements and reviews pricing to ... sure that the claim is billed to the proper payer source, in the proper billing format, with the...contacts with outside individuals on billing issues. + Informs Manager of problem accounts promptly. + Performs schedules hours,… more
- Albany Medical Center (Albany, NY)
- …or Physician office experience, preferred + Strong insurance knowledge regarding payer contract interpretation including Authorization Requirements and Setting ... be able to work in conjunction with Nursing Supervision and Patient Triage Manager for accurate bed assignment for inpatient and observation patients. In addition,… more