- 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
- 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
- Option Care Health (Albany, NY)
- **Extraordinary Careers. Endless Possibilities.** **With the nation's largest home infusion provider , there is no limit to the growth of your career.** Option Care ... the largest independent home and alternate site infusion services provider in the United States. With over 8,000 team...and more impactful. Our organization requires extraordinary people to provide extraordinary care, so we are investing in a… more
- Humana (Albany, NY)
- …- 5 years of experience in negotiating managed care contracts with physician, hospital and/or other provider contracts. + Proficiency in analyzing, understanding ... part of our caring community and help us put health first** The Provider Contracting Professional 2 initiates, negotiates, and executes dental provider contracts… 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
- Oracle (Albany, NY)
- …focus more on patient care by reducing administrative burden of clinical and reimbursement tasks such as charting, documentation, and coding by applying power of ... opportunities to prevent future denials, and ensure maximum appropriate reimbursement . This role is critical for financial recovery and...on experience preparing appeals for claim denials in the hospital and ambulatory setting + 3+ years hands 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)
- …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
- 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)
- …(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 (Schenectady, 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
- 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 ... in the state they reside. + Minimum of 2 consecutive years acute inpatient hospital care experience in critical, intensive care setting within the last 5 years (Not… more