- Stony Brook University (East Setauket, NY)
- …and Outpatient billing requirements (UB-04/837i) and/or CMS Medicare and New York Medicaid reimbursement methodologies. + Knowledge of third party payer ... **Position Summary** At Stony Brook Medicine, a **Revenue Specialist** will provide operational support within the hospital 's Patient Accounting Department.… more
- Humana (Albany, NY)
- …our caring community and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business ... the Pricer Business and System Support team responsible for administering complex Medicaid provider reimbursement methodologies. The associate will support… more
- Humana (Albany, NY)
- …part of our caring community and help us put health first** The Medicare (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business ... Pricer Business and System Support team responsible for administering complex Medicare provider reimbursement methodologies. The business needs of the team… more
- University of Rochester (Canandaigua, NY)
- …and addressing consequential barriers to securing public benefits which may impact hospital reimbursement and timely discharge. + Possesses a nuanced ... Subtype: Regular Time Type: Full time Scheduled Weekly Hours: 40 Department: 500169 Medicaid Enrollment Work Shift: UR - Day (United States of America) Range: UR… more
- Molina Healthcare (Rochester, NY)
- …* Working experience with, and strong knowledge of, various managed healthcare provider compensation and VBP methodologies, primarily across Medicaid and ... live in Georgia _** **Job Description** **Job Summary** Molina Health Plan Provider Network Contracting jobs are responsible for the network strategy and development… more
- FlexStaff (Bronx, NY)
- …IPA's, primary care practices, specialty practices, LHCSA agencies, FQHC's, ancillary providers, hospital systems and other provider groups. This role addresses ... other processes. This role maintains strong relationships with providers while optimizing reimbursement rates and ensuring provider compliance with service level… more
- Centene Corporation (Queens, NY)
- …the need for additional health plan providers + Manage and coordinate customized provider contracts and hospital contracts + Participate in physician and ... experience. Experience with state and federal health programs such as Medicaid and Medicare. Provider relations/contracting experience including solid… more
- Humana (Albany, NY)
- … Provider Contracting Professional 2 initiates, negotiates, and executes physician, hospital , and/or other provider contracts and agreements. The Provider ... years of experience servicing or negotiating managed care contracts with physician, hospital and/or other provider contracts + Proficiency in analyzing,… more
- Humana (Albany, NY)
- …Senior Provider Contracting Professional initiates, negotiates, and executes physician, hospital , and/or other provider contracts and agreements for an ... + 2+ years of network management experience including but not limited to: provider and hospital contracting, network administration in a healthcare company or… more
- Catholic Health Services (Roslyn, NY)
- Overview St Francis Hospital & Heart Center(R), part of the Catholic Health system, is a community hospital located in Roslyn, NY. Founded in 1922 by the ... Franciscan Missionaries of Mary, the hospital is New York State's only specialty designated cardiac...a five-star rating from the Centers for Medicare & Medicaid Services for consistently high patient satisfaction scores. Job… more
- Catholic Health Services (Roslyn, NY)
- Overview St. Francis Hospital & Heart Center(R), part of the Catholic Health system, is a community hospital located in Roslyn, NY. Founded in 1922 by the ... Franciscan Missionaries of Mary, the hospital is New York State's only specialty designated cardiac...a five-star rating from the Centers for Medicare & Medicaid Services for consistently high patient satisfaction scores. Job… more
- Albany Medical Center (Albany, NY)
- …coding. Sequence diagnoses and procedures by following the ICD-10-CM/PCS, CPT4, Uniform Hospital Discharge Data Set (UHDDS), Medicare, Medicaid and other fiscal ... Day (United States of America) Salary Range: $55,895.80 - $83,843.71 The Hospital Coder applies skills and knowledge of currently mandated coding and classification… more
- Saratoga Hospital (Saratoga Springs, NY)
- …Saratoga Hospital is a 171+ bed, independent, locally-governed community hospital and a leading healthcare provider in the region. The ... or Physician Assistant serves as an additional patient care provider , augmenting and extending patient services provided by the...Quality Rating under the US Centers for Medicare & Medicaid Services Hospital Compare Initiative + Commission… more
- J&J Family of Companies (New City, NY)
- …+ Account Management and/or Reimbursement experience working in the hospital and/or provider office setting, building strong customer relationship. + ... to payer approval processes and business acumen. + Understanding of Medicare, Medicaid , and private payer initiatives affecting reimbursement of pharmaceutical… more
- Calvary Hospital (Bronx, NY)
- …in the ongoing marketing of programs and services provided by Calvary Hospital . Works cooperatively with other departments, provider referrers and managed ... by Calvary Hospital . Interfaces with managed care organizations to facilitate reimbursement for services provided by the Hospital . Oversees the appeals… more
- University of Rochester (Rochester, NY)
- …staff to understand and adhere to contract language by payer for appropriate reimbursement to the hospital and ensure the accuracy of account reconciliation. ... knowledge of all current third-party coverage, federal and state billing, and reimbursement and compliance regulations and procedures. + Serves as a contact to… more
- WMCHealth (Valhalla, NY)
- Financial Reimbursement Specialist - On Site Company: NorthEast Provider Solutions Inc. City/State: Valhalla, NY Category: Finance/Info Systems Department: ... of Financial Planning and the Director of Budget & Reimbursement in third party analysis and preparation of internal...+ Gathers data in preparation of Annual Medicare & Medicaid Cost Reports. + Aid in the preparation of… more
- Catholic Health Services (Smithtown, NY)
- …for improvement or appeal. + Regulatory Compliance: Stay up-to-date on current reimbursement regulations and guidelines (eg, Medicare, Medicaid ) and ensure ... Siena Nursing and Rehabilitation and St. Catherine of Siena Hospital are proud members of Catholic Health and have...to offer care to those in need and to provide a spirit of mutual respect while upholding our… more
- Catholic Health Services (Rockville Centre, NY)
- …complex data analysis. The ideal candidate possesses in-depth knowledge of Medicare/ Medicaid reimbursement , managed care contracts, and healthcare finance. Key ... cost reporting, or financial analysis. + Strong knowledge of Medicare and Medicaid regulations, reimbursement methodologies, and healthcare payment systems. +… more
- University of Rochester (Brighton, NY)
- …Law, the False Claims Act, Civil Monetary Penalties, and + Medicare and Medicaid billing regulations (including CMS, Medicare Advantage and New York State ... Medicaid ). + Manage disputes, risks and projects related to...to the Office of Integrity and Compliance on relevant reimbursement and billing issues and requirements (including CMS, Medicare… more