- KPH Healthcare Services, Inc. (Camden, NY)
- …for collecting, posting and managing account payments. + Prepares and submits claims to various insurance companies and follow up when appropriate. + Prepare, ... review and issue patient statements. Resolve patient billing complaints/issues. + Performs various collection actions. + Maintains strictest confidentiality, adheres to all HIPAA guidelines and regulations. **Qualifications** **Qualifications:** Preferred: 1-2… more
- GE Vernova (Schenectady, NY)
- …assess for trends to support service actions, etc.) + Build and track claims for assigned commodities and/or failure type using recovery workflow process + Identify ... data quality improvement opportunities and support Vendor Recovery Leader in working cross-functionally in implementing improvements + Support Vendor Recovery efforts with data packages (cost and defect details) that will improve our recovery response time and… more
- CVS Health (Albany, NY)
- …abuse. + Conduct Investigations to prevent payment of suspect or fraudulent claims submitted by insured's, providers, claimants and customers. + Researches and ... prepares cases for clinical and legal review. + Documents all appropriate case activity in case tracking system. + Prepare written case summaries and make referrals to State and Federal Agencies within the timeframes required by Law. + Facilitates the recovery… more
- Constructive Partnerships Unlimited (Brooklyn, NY)
- …the code of business conduct, the NYS and federal false claims acts, whistleblower protections and mandatory reporting. Completes corporate compliance training ... at least annually . Fully cooperates in all corporate compliance investigations and reviews. B. Essential Physical Requirements 1. The ability to coordinate the movement of the arms, legs, and torso together in activities where the whole body is in motion,… more
- CVS Health (Albany, NY)
- …that align with strategic goals. + **Drive Strategy:** Collaborate with sales, claims , and customer service teams to develop tailored underwriting strategies based ... on market trends and business objectives. + **Mentor & Guide:** Share your expertise by mentoring peers, reviewing work for accuracy, and identifying training opportunities. + **Ensure Compliance:** Conduct audits, track allowances, and ensure all financials… more
- Walmart (East Syracuse, NY)
- …aligned with company and regulatory standards for prescriptions and claims , doctor and optician certifications/licensure, and associate training. Guides associates ... and supports managers on how to address customer and member concerns and merchandise defects. Meets with managers, doctors, and associates to identify and discuss any concerns and issues related to the business and to share information related to new… more
- Lowe's (Syracuse, NY)
- …Maintains continuous dialogue with 3PL vendor partner(s) to address and resolve claims and complaints received involving In Home Customer Delivery experiences. + ... Reviews Market-level productivity and quality metrics with Markets on a Daily/Weekly and Monthly basis and utilizes this information to drive operations improvements at the Market level. **Minimum Qualifications** * Bachelor's Degree - Operations, Supply… more
- Defense Health Agency (Fort Drum, NY)
- …for federal civilian healthcare providers as they are covered by the Federal Tort Claims Act (28 USC | 1346(b)) while acting within the scope of their employment. ... A recruitment or relocation bonus may be authorized. http://www.drum.amedd.army.mil/SitePages/ http://www.military.com/base-guide/fort-drum **This is a Direct Hire Announcement** **Who May Apply: US Citizens** **Responsibilities** **Description:** Scope of… more
- CVS Health (New York, NY)
- …NextGen Production Support Environment team, focusing on Non-Production Support: + Claims system: Health Rules Payer (HRP) + Enrollment systems: Market Prominence ... (MP) & Softheon The position requires collaboration with business, QA, release delivery, infrastructure, and vendor partners, driving system stability and maintaining code releases. Key Responsibilities + Monitor system upgrades. + Analyze defect reports… more
- CVS Health (Albany, NY)
- …routine nature. + Handle incoming calls from members and providers regarding claims status, benefits and eligibility, PPO participation, etc + Maintain department ... established performance metrics at a meets or exceeds expectations level + Work together as a team and apply the Aetna Core Values in day-to-day operations + Creating a Differentiated Service Experience + Demonstrating Service Discipline + Handling Service… more