- OLV Human Services (Lackawanna, NY)
- …+ Comfort using computers (NextGen experience a plus) + High school diploma required; Associate 's degree preferred Why You'll Love It Here: + Make a positive impact ... and denials * Utilizes denial reports to assess root causes of dental claim denials monitor denials for frequency, eligibility, clinical; takes necessary action to… more
- Humana (Albany, NY)
- …CFOs, clinical teams, and provider engagement teams, focusing on Medicaid claims and premium analytics across multiple states, including established and expansion ... data connecting financial outcomes with operational results, particularly in Medicaid claims and premiums. + Deliver project-based and ad-hoc reporting for Medicaid… more
- Humana (Albany, NY)
- …**Required Qualifications** + Bachelors Degree + Minimum of 3 years of medical claims auditing experience (interpreting if claims initially paid correctly in the ... Payment Integrity (formally known as Financial Recovery) experience + CAS claims knowledge + Prior vendor relationship experience/knowledge + Intermediate knowledge… more
- New York State Civil Service (Schenectady, NY)
- …position will process quarterly Payer Penalty requests for review submitted by claims administrators. Specific duties include, but are not limited:* Demonstrate a ... sections of the WCL, Board policies and procedures, and claims handling procedures for WC claims .* Display...to technical questions from policyholders or claimants;Or 2. An associate 's degree and two years of full-time experience described… more
- Teresian House (Albany, NY)
- …Care Organizations (MCO's) and private insurance. + Preparing and submitting claims , resolving billing issues, managing accounts receivable, and working with ... formats. Monitor and manage outstanding balances and follow-up on unpaid claims . + Communicating with families, residents and insurance companies regarding account… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …in a clear and concise manner. + Analyzes proactive detection reports and claims data to identify red flags/aberrant billing patterns. + Manages cases as assigned, ... in FWA investigations and audits; or five years of insurance claims investigation experience or professional investigation experience with law enforcement agencies;… more
- Otsuka America Pharmaceutical Inc. (Albany, NY)
- …and external regulations. This position reports directly to the Associate Director, CNS Scientific Communications. **Job Description** **Key Responsibilities ... **Core Content Development** + Under the guidance of the Associate Director, Medical Communications, draft and maintain high-priority, foundational scientific… more
- City of New York (New York, NY)
- …enforcement tools to address allegations of discrimination. Reporting to the Associate Commissioner for Law Enforcement, the Supervising Attorney will help manage ... in conducting interviews with members of the public alleging claims of discrimination in employment under the NYCHRL and...and at bar associations. - Advising the Deputy & Associate Commissioner on proposed legislation and other policy matters.… more
- Paychex (Rochester, NY)
- …in unemployment hearings to ensure that the client is best represented and the claim is adjudicated effectively and in the best interest of the client. + Researches ... Mentors and trains SUI Client Maintenance Specialists and SUI Claim Specialists to provide direction and assistance on daily...and efficiencies. Qualifications + HS Diploma - Required + Associate 's Degree - Preferred Compensation In the spirit of… more
- Helio Health Inc. (Gloversville, NY)
- …has not done so. + Consistent follow up with all insurance companies to work claim denials. + Prepares weekly and monthly reports of Medicaid billing for the Manager ... other duties as assigned. Qualifications + High School Degree /GED required, Associate 's degree preferred. + Excellent verbal and written communication skills. +… more