• Pharmacy Contracting Professional 2

    Humana (Albany, NY)
    …and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to ... 2 ensures contract compliance and performs analysis regarding pharmacy claims . Understands department, segment, and organizational strategy and operating objectives,… more
    Humana (11/21/25)
    - Related Jobs

  • Assistant Insurance Fund Services Representative

    New York State Civil Service (Albany, NY)
    …Case Manager in the NYS Segment.* Work up and process Workers' Compensation claims .* Approve and deny medical bills.* Respond to claimant and provider inquiries via ... phone and email.* Routinely communicate with employers to obtain info about claims .* File forms and correspond with the Workers' Compensation Board.* Review … more
    New York State Civil Service (11/14/25)
    - Related Jobs

  • Long Term Care Benefits Planner I/II (Rochester…

    Excellus BlueCross BlueShield (Rochester, NY)
    …with the arrangement of services as is deemed necessary. + Evaluates submitted claims to determine if services billed and provided are consistent with the approved ... claim payment to encourage timely submission and adjudication of claims within company and State time service standards. +...In lieu of an RN or bachelor's degree, an associate 's degree or LPN with a minimum of two… more
    Excellus BlueCross BlueShield (11/08/25)
    - Related Jobs

  • Contract Specialist

    Family and Children's Association (Mineola, NY)
    …is responsible for timely preparation, submission and payment reconciliation for claims submitted to various funding sources (local, state and federal government, ... billing data for accuracy and integrity, monitor contract budgets, and support compliance with funding and accounting guidelines. Responsibilities + Prepare and… more
    Family and Children's Association (11/07/25)
    - Related Jobs

  • Broker II, National Casualty Practice

    AON (New York, NY)
    …include identification of: differences against expiring, coverage trigger (occurrence, claims made, occurrence reported), surplus lines or admitted, auditable or ... clients + Works closely with account executives, producers, and client teams to support client retention and new business production. + Articulates the value of the… more
    AON (11/22/25)
    - Related Jobs

  • Medicaid Provider Hospital Reimbursement…

    Humana (Albany, NY)
    …team responsible for administering complex Medicaid provider reimbursement methodologies. The associate will support existing Medicaid business and expansion ... and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to… more
    Humana (11/17/25)
    - Related Jobs

  • Admin Secretary

    Catholic Health Services (Greenvale, NY)
    …our medical practice. In this role, you will provide essential administrative support to our healthcare team, ensuring smooth and efficient office operations. Your ... will help create a welcoming environment for patients and support the delivery of high-quality care. Job Details Key...with billing processes, including insurance verification, coding, and processing claims . Follow up on unpaid claims and… more
    Catholic Health Services (10/18/25)
    - Related Jobs

  • National Accounts: Dedicated Field Services…

    CVS Health (Albany, NY)
    … to members as well as navigating them through the health system, providing support on claims issues, and answering coverage-level questions. **We have two of ... any benefits related issues including answering routine questions, addressing denied claims , preauthorization, and providing support to both the employees… more
    CVS Health (09/05/25)
    - Related Jobs

  • Senior Customer Service Representative

    Momentive Performance Materials Inc. (Niskayuna, NY)
    …Summary:In this role, you will be the primary contact for customer support -related activities. You will provide best-in-class or excellent customer service for ... and play a key role as a profitability driver by offering proactive support to sales and customers, ensuring the execution and exceeding of customer expectations… more
    Momentive Performance Materials Inc. (11/07/25)
    - Related Jobs

  • Quality Management Nurse Consultant

    CVS Health (Albany, NY)
    …accreditation requirements. + Apply clinical criteria and policies to member/provider claims and coordinate clinical resolutions with MD support . **Performance ... reports to the State in collaboration with Informatics. **Policy Development & Peer Support ** + Author and revise internal policies and contribute to peer review of… more
    CVS Health (11/20/25)
    - Related Jobs