Health Management Systems

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HMS Holdings Corp., through its subsidiary, Health Management Systems, Inc. (HMS), provides cost containment, coordination of benefits, and program integrity services to government healthcare programs in the United States. Coordination of benefits services route claims already paid by a government program to the liable third party, which then reimburses the government payor. Cost avoidance services provide validated insurance coverage information that is used by government payors to reject claims that are the responsibility of a third party, typically a group health plan sponsored by a beneficiary’s employer. Program integrity services review claims paid by government programs, identify payments errors, and then recoup the erroneous payments. The company also provides Medicare bad debt cost reporting and Disproportionate Share claiming services to healthcare providers. These services enable customers to increase revenues, reduce costs, and ensure regulatory compliance. The company’s customers include State Medicaid agencies, government-sponsored managed care plans, child support agencies, SCHIP programs, the Veterans Health Administration, and other public programs. It helps these programs contain healthcare costs by identifying third party insurance coverage and recovering expenditures that were the responsibility of the third party, or that were paid in error. HMS Holdings was founded in 1974 and is headquartered in New York, New York.

Specialties

Medicaid

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Job Title Location Hiring Manager
Medical UR Manager -- mgmt role in start-up environment, build your own team Greater Boston Area

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Last edited by at HMS Holdings Corp.

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