- City of New York (New York, NY)
- Job Description APPLICANTS MUST BE PERMANENT IN THE FRAUD INVESTIGATOR CIVIL SERVICE TITLE OR IN A COMPARABLE TITLE ELIGIBLE FOR 6.1.9. The DSS Accountability Office ... fraudulent acts against the social service programs administered by HRA/DSS. The Medicaid Investigations Division (MID) is mandated to provide expanded levels of… more
- City of New York (New York, NY)
- …that will go before trials and hearings. The responsibilities of the Associate Investigator will include but not limited to: - Investigate complaints received by the ... officials. - Develop effective working relationships with NYC agencies, NYS Office of Medicaid Inspector General, NYS Department of Health, NYS Office for the Aging,… more
- Molina Healthcare (New York, NY)
- **JOB DESCRIPTION** **Job Summary** The SIU Coding Investigator is responsible for investigating and resolving instances of healthcare fraud and abuse by medical ... legal processes (Commercial insurance, Medicare, Medicare Advantage, Medicare Part D, Medicaid , Tricare, Pharmacy, etc.) + Experience with UNET, Comet, Macess/CSP,… more
- CVS Health (Trenton, NJ)
- …in the United States. We are seeking an experienced Senior Healthcare Fraud Investigator to join our Special Investigations Unit (Aetna SIU). In this role, you ... + Pharmacy Investigative experience + Marketplace Broker Investigative experience + Medicaid and Medicare experience **Education** + Bachelor's degree or equivalent… more
- Humana (Trenton, NJ)
- …leading to a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at large. **Equal ... Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information,… more
- Mount Sinai Health System (New York, NY)
- **Job Description** **Accounting Clerk- Patient Financial Services (Medicare & Medicaid Claims Follow-Up)-Corporate 150 East 42nd Street - Full-Time Days** Under the ... including but not limited to financial verification, preparation of Medicaid applications, billing, processing accounts, payment and/or charge posting, account… more
- Mount Sinai Health System (New York, NY)
- …**Accounts Payable Receivable Clerk- Patient Financial Services (Medicare & Medicaid Claims Follow-Up))-Corporate 150 East 42nd Street - Full-Time Days** ... of Health funding and in the 99th percentile in research dollars per investigator according to the Association of American Medical Colleges. Newsweek's "The World's… more
- Mount Sinai Health System (New York, NY)
- …entitlement services. + REAP assists with a range of government programs including Medicaid , Medicare, Child Health Plus, Essential Plan, SNAP & others. + In ... the social worker will attend trainings with NYC HRA Medicaid as part of REAP's role as a community...and in the 99th percentile in research dollars per investigator according to the Association of American Medical Colleges.… more
- Mount Sinai Health System (New York, NY)
- …interest in health economics, health services research, and health policy, especially Medicaid policy. The fellow will join the Postpartum Outcomes and Extension of ... Medicaid (POEM for Equity) team on a NIH funded...and in the 99th percentile in research dollars per investigator according to the Association of American Medical Colleges.… more
- Mount Sinai Health System (New York, NY)
- …compliance related to Facility Contracts for all Commercial, Medicare Advantage and Medicaid Managed Care Plans. The team serves as MSHP's subject matter experts ... to drive performance for value-based contracts for Medicare Advantage, Managed Medicaid and Commercial arrangements. * Support the development of strategies and… more
- Mount Sinai Health System (New York, NY)
- …for evaluating and driving performance for value-based contracts including Medicare, Medicaid and commercial arrangements. The Senior Director is a key member ... value-based contracts inclusive of risk and opportunity identification for Medicare, Medicaid and Commercial arrangements. 2. Develop strategies and alternatives for… more
- Mount Sinai Health System (New York, NY)
- …drug programs to assist with out of pocket expenses, referral for Medicaid /charity care assistance when applicable, billing to co-pay programs and foundations, and ... option for the patient is a referral to the Medicaid Application team for possible charity care enrollment. +...and in the 99th percentile in research dollars per investigator according to the Association of American Medical Colleges.… more
- Mount Sinai Health System (New York, NY)
- …generates patients chart and attaches pertinent information such as Emerg Card, Medicaid threshold and EMS sheet, etc. 10. According to policy and established ... of Health funding and in the 99th percentile in research dollars per investigator according to the Association of American Medical Colleges. Newsweek's "The World's… more
- Mount Sinai Health System (New York, NY)
- …crisis as federal and state governments are unable to keep Medicare & Medicaid solvent, employers are stretched to pay for health benefits for their employees, ... of Health funding and in the 99th percentile in research dollars per investigator according to the Association of American Medical Colleges. Newsweek's "The World's… more
- Mount Sinai Health System (New York, NY)
- …as necessary. 3. Functions as liaison to insurance companies and the Medicaid Eligibility Office, including screening requests for medical necessity, obtaining prior ... of Health funding and in the 99th percentile in research dollars per investigator according to the Association of American Medical Colleges. Newsweek's "The World's… more
- Mount Sinai Health System (New York, NY)
- …* Reviews and disseminates information pertaining to Centers for Medicare & Medicaid Services (CMS), The Joint Commission (TJC), New York State Department of ... of Health funding and in the 99th percentile in research dollars per investigator according to the Association of American Medical Colleges. Newsweek's "The World's… more
- Mount Sinai Health System (New York, NY)
- …are insured by a combination of, eg, commercial insurers, Medicare Advantage Plans, Medicaid Managed Care Plans, employers, and unions. **This is a hybrid position ... of Health funding and in the 99th percentile in research dollars per investigator according to the Association of American Medical Colleges. Newsweek's "The World's… more
- Mount Sinai Health System (New York, NY)
- …financial assistance for patients with government-sponsored health plans including Medicare , Medicaid and TriCare. Preferred: 3 years of health care related billing ... of Health funding and in the 99th percentile in research dollars per investigator according to the Association of American Medical Colleges. Newsweek's "The World's… more
- Mount Sinai Health System (New York, NY)
- …such as IDX, Soarian, etc. ? Knowledge of the New York State Medicaid and CMS Medicare regulations and related reporting requirements, such as STARS,QARR, MMCOR, ... of Health funding and in the 99th percentile in research dollars per investigator according to the Association of American Medical Colleges. Newsweek's "The World's… more
- Mount Sinai Health System (New York, NY)
- …crisis as federal and state governments are unable to keep Medicare & Medicaid solvent, employers are stretched to pay for health benefits for their employees, ... of Health funding and in the 99th percentile in research dollars per investigator according to the Association of American Medical Colleges. Newsweek's "The World's… more