- Humana (Albany, NY)
- …cycle management (related to billing, coding, collections for Medicare and Medicaid claims ) + Experience with Auditing and monitoring of healthcare records + Must ... be able to work core business hours on EST time between (9am-5pm). + Willingness to travel up to 10% to conduct audits at site locations. + Ability to manage multiple or competing priorities and meet deadlines + Must be passionate about contributing to an… more
- City of New York (New York, NY)
- …active contracts. - Direct the processing of approximately 30,000 Medicaid reimbursement claims per month, related to a class-action settlement. - Develop and ... enforce accounting policies, internal controls, and financial reporting systems within FMS to ensure compliance and efficiency. - Verify expenditures and program eligibility through the Passport system and close coordination with HRA/DHS program areas. -… more
- Guardian Life (New York, NY)
- …(classification, OCR/layout understanding, entity/table extraction, summarization) across underwriting, claims , and customer service. + Design and ship ... retrieval-augmented solutions (RAG/grounded generation, vector search, conditional routing) for policy, clinical, and knowledge assets. + Build agentic automations and AI bots for intake, triage, and workflow orchestration; integrate with core systems and… more
- Singer (Melville, NY)
- …of equipment for inbound, outbound, and offsite. + Negotiating freight claims , experience preferred. + Preparing and tracking sales agreements, experience preferred. ... Ideal Candidate Will Possess the Following Skills and Abilities + High School diploma or equivalent. + Minimum of 1 year of related experience. + Demonstrated ability to work in a collaborative team environment. + Must be able to work independently while… more
- The Estee Lauder Companies (New York, NY)
- …consumer segment (ie Multi Ethnic Millennials) relevant and deliver clear communication of claims & benefits + Identify and validate trends and develop a deliberate ... model/mix for the Brand to win; inspire new product innovation by category and subcategory with analytical rigor + Enhance insights and creativity through analytics; reverse engineer initiative opportunities to ensure sufficiency vs. market and use KPIs to… more
- WTW (New York, NY)
- …day to day service issues and questions (eligibility, carrier coverage and claims issues, compliance, etc.) + Preparing for and facilitating client meetings (prepare ... agendas and materials, coordinate resources, etc.) + Contributing to benefit plan analysis, design, cost savings and funding strategies + Engaging subject matter experts to address client needs + Conducting review of client deliverables to ensure alignment to… more
- Philadelphia Insurance Companies (Melville, NY)
- …the Philadelphia Insurance Companies, Tokio Marine America, Inc., TMNA Services, LLC, TM Claims Service, Inc. and First Insurance Company of Hawaii, Ltd.) is an ... Equal Opportunity Employer. In order to remain competitive we must attract, develop, motivate, and retain the most qualified employees regardless of age, color, race, religion, gender, disability, national or ethnic origin, family circumstances, life… more
- Molina Healthcare (Buffalo, NY)
- …advanced SQL queries to extract, validate, and analyze healthcare data, including claims , authorization, pharmacy, and lab datasets. * Build and maintain efficient ... ETL pipelines to support ongoing reporting and analytics workflows. * Utilize Databricks and Snowflake to develop scalable data pipelines and analytical datasets. * Create and maintain Power BI dashboards to deliver insights on utilization, outcomes, and cost… more
- Molina Healthcare (Syracuse, NY)
- …experience working in Medicare + Must have experience analyzing claims . **Job Qualifications** **REQUIRED EDUCATION:** Associate's Degree and/or equivalent ... combination of education and Health Care related experience of 4+ years **REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES:** 4+ years experience in health care industry in related field **PREFERRED EDUCATION:** Bachelor's degree in healthcare related field… more
- Catholic Health Services (Centereach, NY)
- …similar EMR platforms Experience with retail pharmacy prescription processing and claims adjudication Prior experience on pharmacy dispensing systems and familiar ... with insurance adjudication processes This role involves working with a broad array of complex disease states and medical conditions. Candidates should be comfortable working with clinical data, lab values, and reading/writing notes in patient medical records… more