- Citigroup (Getzville, NY)
- …Associate Analyst is responsible for investigating and settling compensation claims internally and externally for the EMEA and NA Capital Market products; ... the front office, operations, relationship managers and external clients. Analyst is expected to be able to: * Support...systems; investigate the root cause behind the delay; issue claims internally and externally; follow up until claim… more
- Molina Healthcare (Albany, NY)
- …and executing operational initiatives tied to Payment Integrity (PI) and provider claims accuracy. The individual will be relied upon to make independent, informed ... coordination, and ownership of high-value deliverables-distinct from a pure data analyst role. **Job Duties** **Business Leadership & Operational Ownership** +… more
- City of New York (New York, NY)
- Job Description APPLICANTS MUST BE PERMANENT IN THE ADMINISTRATIVE STAFF ANALYST CIVIL SERVICE TITLE The Bureau of Revenue Optimization and Automation (BROA) ... SQL algorithms and EDW data, analyzing data to identify claims that can be reclaimed for higher federal and...reclaimed for higher federal and state reimbursement rates, preparing claim adjustments to maximize federal and state funding, providing… more
- Molina Healthcare (Albany, NY)
- …and financial outcomes for all PI solutions. + Leads efforts to improve claim payment accuracy, claim referrals, adjustment analysis and financial performance ... a business lens to ensure accurate interpretation of provider claims trends, payment integrity issues, and process gaps. +...At least 7 years of experience as a Business Analyst or Program Manager in a Managed Care Organization… more
- City of New York (New York, NY)
- …medical records requests from MCO to obtain prior authorization approvals and claim reimbursement. - Review all claims CPT/ICD-10/HCPCS, payment modifiers in ... perform health insurance billing activities and support functions including claim review, claim submission, follow up and...denials in a timely manner. - Prepare and batch claims out to third party payers for reimbursements. -… more
- MTA (New York, NY)
- …for the overall management of a staff of 2 people including the Sr Claims Administrator, 1 Analyst and approximately 7 consultants. + Responsible for the ... and assess loss picks, ensuring accuracy in estimating future claims costs. Oversees OCIP claims and settlements...cost, accuracy and best practices. + Monitors and manages claim reserves, working with TPAs and insurers to adjust… more
- MTA (New York, NY)
- …reduce the MTA's cost of risk through risk analysis and transfer, claims management practices, captive financial planning, insurance program placement, and other ... overall management of a staff of two: a senior analyst and a consultant. Select, develop, and motivate personnel...handling All Agency Fiduciary, Fidelity, and agency property insurance claims ( Claims valued over $100 million are… more
- City of New York (New York, NY)
- Job Description APPLICANTS MUST BE PERMANENT IN THE ADMINISTRATIVE STAFF ANALYST CIVIL SERVICE TITLE OR IN A COMPARABLE TITLE ELIGIBLE FOR 6.1.9. The Department of ... Analytics & Verification is recruiting for (1) Administrative Staff Analyst NM III to function as an Executive Director,...- Design, test, and implement the process to evaluate claims for skimming reimbursement in a batch, data-driven manner,… more
- City of New York (New York, NY)
- Job Description APPLICANTS MUST BE PERMANENT IN THE ADMINISTATIVE STAFF ANALYST CIVIL SERVICE TITLE OR BE PERMANENT IN A COMPARABLE TITLE ELIGIBLE FOR 6.1.9 TITLE ... Office of Revenue Management and Development is recruiting one (1) Administrative Staff Analyst NM2 to function as a Director of Revenue Enhancement and Analysis.… more
- Highmark Health (Albany, NY)
- …of related, progressive experience + Experience as a forecasting or scheduling analyst OR experience in a call center environment using automated scheduling tools ... Vue, and Access + Knowledge of OSCAR, INSINQ and claim flow + Ability to create/use ad hoc reports...+ Ability to create/use ad hoc reports to investigate claim and inquiry related issues and trends, document findings… more