- 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 Sr. Medicare (PPS) Provider Hospital Reimbursement Analyst will be an integral part of the ... of the team as it expands to accommodate the increased responsibilities. The Provider Hospital Reimbursement Analyst r will be primarily responsible… more
- Humana (Albany, NY)
- …executing upon said strategy. Communicates contract terms, payment structures, and reimbursement rates to providers. Analyzes financial impact of contracts and ... responsibility for developing contracting methodologies and foster relationships with large hospital systems. Maintains metrics and health quality based goals to… 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
- Molina Healthcare (Albany, NY)
- …experience in Managed Care + 5 or more years hospital reimbursement methodologies + Background in provider contracts, pricing configuration, claim ... The Lead Analyst, Reimbursement is responsible for administering complex provider reimbursement methodologies timely and accurately. Supports existing lines… more
- Trinity Health (Albany, NY)
- …Access or Patient Accounting for hospital registration and / or hospital reimbursement services Obtain National certification in HFMA CRCR and/or NAHAM ... on patient accounts and works with patients or their representatives to provide financial assistance or secure payment. **Essential Functions** **Our Trinity Health… more
- Molina Healthcare (Albany, NY)
- …and/or functional requirements related to but not limited to coverage, reimbursement , and processing functions to support systems solutions development and ... **JOB DUTIES** + Develops and maintains requirement documents related to coverage, reimbursement and other applicable system changes in areas to ensure alignment to… more
- Ellis Medicine (Schenectady, NY)
- …degree preferred. + Experience: 2 years of accounts receivable experience in a hospital or healthcare setting preferred. + Must have knowledge of medical records, ... patients. + Claims in dispute with payers are reviewed daily to ensure the provider and payers are in agreement for appropriate claims reimbursed. + Monthly meetings… more
- Grifols Shared Services North America, Inc (Albany, NY)
- …territory including major accounts and large players (ie, Commercial, Medicare, and Medicaid ) *Understanding of Hospital formulary with guidance of RSD and ... to fulfill customer needs and impact pull-through (eg, MSL, IG Nurse Educator, reimbursement specialist) *Gather and provide customer insights to Marketing teams… more
- Molina Healthcare (Albany, NY)
- …modeling current and future contract rate proposals. * Research, analyze, and consult Medicaid and Medicare reimbursement methodologies, evaluate the impact of ... Business Intelligence tools (Medinsight, PowerBI), and Executive Dashboard. * Generate hospital performance analytics tools on a quarterly basis; develop reports on… more
- Molina Healthcare (Albany, NY)
- …modeling current and future contract rate proposals. + Research, analyze, and consult Medicaid and Medicare reimbursement methodologies, evaluate the impact of ... Business Intelligence tools (Medinsight, PowerBI), and Executive Dashboard. + Generate hospital performance analytics tools on a quarterly basis; develop reports on… more
- Molina Healthcare (Albany, NY)
- …(UB04/1500 form). * Advanced understanding of key managed care concepts and provider reimbursement principles such as risk adjustment, capitation, FFS ... from functional areas such as finance, health care services and provider contracting to translate analytic observations into meaningful clinical/operational actions… more
- St. Catherine's Center for Children (Albany, NY)
- …is admitted and/or discharged from a health care facility, including ER and inpatient hospital stays, will provide transitional care to ensure the continuity of ... comprehensive care planning, ongoing care coordination, and community linkage to Medicaid eligible children with complex physical and behavioral health conditions… more
- Humana (Albany, NY)
- …for services rendered is complete, compliant and accurate to support optimal reimbursement . The Nurse Auditor 2 work assignments are varied and frequently require ... guidelines. Applies clinical experience when conducting chart reviews of hospital and facility billing. Understands department, segment, and organizational strategy… more