- 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
- 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
- Cognizant (Albany, NY)
- We strive to provide flexibility wherever possible. Based on this role's business requirements, this is a remote position open to qualified applicants in the United ... Monday to Friday - Eastern Time **About the role:** Asan AR Physician Hospital Billing Follow Up, you will be responsible for resolving aged hospital… 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
- MVP Health Care (East Greenbush, NY)
- …sales environment, with some experience in the health care industry such as a hospital , medical office, or health insurance company. + The ability to speak more than ... individuals and seamlessly enrolling them in a variety of plans including Medicaid , Child Health Plus, Essential Plan, Qualified Health Plans (QHPs), HARP,… more