- Humana (Albany, NY)
- **Become a part of our caring community and help us put health first** The Payment Integrity Coding Professional within Code Edit Vendor Management ... of situations or data requires an in-depth evaluation of variable factors. The Payment Integrity Coding Professional monitors and analyzes Code Edit… more
- Highmark Health (Albany, NY)
- …consistent with established industry and corporate standards and are within the Payment Integrity Clinician's professional discipline.Effectively function in ... The incumbent is responsible for the implementation of effective Payment Integrity strategies on a pre- payment...coding criteria, as well as other approved guidelines, payment and medical policies.Promote quality and efficiency in the… more
- Ellis Medicine (Schenectady, NY)
- The Supervisor, Medical Coding - Outpatient is responsible for the oversight and development of the office coding department. This includes mentorship and direct ... management of the outpatient medical coding team. The Supervisor of Medical Coding ...EDUCATION AND EXPERIENCE REQUIREMENTS: + Bachelors Degree + Certified Professional Coder (CPC) + Knowledge of Anatomy and Physiology,… more
- Elevance Health (New Hyde Park, NY)
- …be considered for employment, unless an accommodation is granted as required by law. Carelon Payment Integrity is a proud member of the Elevance Health family of ... Manager of DRG Coding Audit-Program/Project Locations: _The selected candidate must reside...companies, Carelon Insights, formerly Payment Integrity , is determined to recover, eliminate… more
- Trinity Health (Albany, NY)
- … coding guidelines, payer regulations, compliance and reimbursement and the effects of coding in relation to risk adjustment payment models. . Identify ... **Employment Type:** Full time **Shift:** Day Shift **Description:** Risk Adjustment Coding Specialist -St. Peter's Health Partners - Full-time - Remote **POSITION… more
- MVP Health Care (Schenectady, NY)
- …in New York State + A minimum of three (3) years' experience in a professional coding environment and three (3) years' experience in auditing and/or reviewing in ... If you have a passion for managing audits, medical coding , and analytical thinking and this is the opportunity...+ Collect and validate Key Performance Indicators (KPI's) from payment integrity functions across the organization. +… more
- Ellis Medicine (Niskayuna, NY)
- …support a work-life balance, including 6 paid holidays + Tuition Reimbursement and professional development opportunities + Retirement plan in the form of a 401(3b) ... and related encounter forms, ensuring compliance with CPT/HCPCS and ICD-9/ICD-10 coding guidelines and government regulations, responsible for reviewing and … more
- Ellis Medicine (Schenectady, NY)
- …complete manner. Requirements: High School Diploma or Equivalent required. Certified Professional Coder (CPC), Certified Coding Specialist (CCS), Registered ... and related encounter forms, (4) ensuring compliance with CPT/HCPCS and ICD-10 coding guidelines and government regulations, responsible for reviewing and coding … more
- University of Rochester (Albany, NY)
- …system to ensure the production of quality healthcare data and accurate professional payment . Prepares reports for designated leader(s). **ESSENTIAL FUNCTIONS** ... Administrator (RHIA) or (Registered Health Information Technician) RHIT or Certified Coding Specialist (CCS). preferred or + Certified Professional Coder… more
- University of Rochester (Rochester, NY)
- …Embedded in that ideal are the values we share: equity, leadership, integrity , openness, respect, and accountability. Together, we will set the highest standards ... and outpatient services. Follows patients through their course of treatment to ensure payment for the service, as well as coverage for the necessary medications… more
- WellLife Network (NY)
- …or payment issues requiring advanced knowledge of payer rules, coding and reimbursement guidelines. 5. Ensure compliance with federal and state regulations, ... and administrative teams to ensure documentation accuracy and maintain revenue integrity . 7. Support internal and external audits by providing billing documentation… more
- Nuvance Health (Poughkeepsie, NY)
- …Robotic Center of Excellence At Vassar Brothers Medical Center, we inspire the professional growth of our team members and support a philosophy of shared ... ensure accurate patient identification and identify and secure appropriate payment sources. Performs registration functions, insurance eligibility verification, patient… more
- Northwell Health (Melville, NY)
- …records, which includes detailing patient demographics as well as updating payment and medical insurance information. + Processing patient payments and refunds. ... + Identifying medical coding mistakes, as well as patient underpayments or overpayments...reports, and claims correspondence to assure accurate and timely payment of accounts. + Verifies completeness and accuracy of… more
- Nuvance Health (Carmel, NY)
- …accurate patient identification and identify and secure appropriate payment sources. Performs registration functions, insurance eligibility verification, patient ... and / or physicians, staff, co-workers, and guests promptly and in a professional manner. Checks patients into the system and provides direction based on appointment… more
- Nuvance Health (Poughkeepsie, NY)
- …accurate patient identification and identify and secure appropriate payment sources. Performs registration functions, insurance eligibility verification, patient ... and / or physicians, staff, co-workers and guests promptly and in a professional manner. Checks patients into the system and provides direction based on appointment… more
- University of Rochester (Rochester, NY)
- …Embedded in that ideal are the values we share: equity, leadership, integrity , openness, respect, and accountability. Together, we will set the highest standards ... claims resolution representative II is responsible for working across the professional fee organization, performing routine follow-up activities designed to bring… more
- Nelnet (Albany, NY)
- …a professional services company, consumer loan originator and servicer, payment processor, renewable energy innovator, and K-12 and higher education expert (and ... lives through the power of service as a student loan servicer, professional services company, consumer loan originator and servicer, payments processor, renewable… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …clinical expertise on ARD cases, Quality of Care cases, clinical editing, coding reviews and inquiries. + Makes accurate and consistent interpretation of integral ... based on changes in healthcare. + Consistently demonstrates high standards of integrity by supporting the Lifetime Healthcare Companies' mission and values, adhering… more
- National Health Care Associates (Poughkeepsie, NY)
- …reimbursement for services provided. You will ensure the highest level of revenue integrity and compliance to all state and federal regulations for MDS completion ... and coding conventions. **Key Responsibilities:** + Lead and oversee the...compliance and accuracy in assessments + Determine Patient Driven Payment Method (PDPM) and expense associated with a potential… more