- Humana (Albany, NY)
- …responsible for administering complex Medicaid provider reimbursement methodologies. The associate will support existing Medicaid business and expansion into new ... closely with IT, the pricing software vendor, CIS BSS, Medicaid operations, claims operations, and other business teams involved in the administration of Medicaid… more
- Sedgwick (Albany, NY)
- … Associate degree from an accredited college or university preferred . Active property & casualty insurance agent/producer license. **Experience** + **High ... At least 1 year of customer service experience; call center experience strongly preferred + Strong verbal communication and active listening skills + Proficiency in… more
- Catholic Health Services (Melville, NY)
- …Helps to resolve problems and recommends solutions, including documentation design and claim editing in the EMR, where there is opportunity for improvement. Actively ... assigned departments/specialties. POSITION REQUIREMENTS AND QUALIFICATIONS: Minimum Education Requirements Associate 's Degree with 5 years of coding or coding/billing… more
- Mount Sinai Health System (New York, NY)
- …accounts or untimely filing. **Qualifications** + **Assoicate Degree. Bachelor?s Degree Preferred or equivalent working experience required.** + **5 years of ... and troubleshoot root causes, if/when needed. + Assist with reviewing and maintaining claim edits and identify edit discrepancies based on coding guidelines and make… more
- Compass Group, North America (Brooklyn, NY)
- …Office Risk Management team in responding to or managing any safety and claims issues* Working with operations and culinary teams to ensure the timely completion ... and settling of team members, foodborne illness, liquor liability and guest claims * Work with local OSHA, sanitation or Everclean inspectors to support inspections… more
- Wright Beverage Distributing Corp. (Rochester, NY)
- …HRIS accuracy, coordinates recruitment logistics, handles offboarding and unemployment claims , and supports compliance activities. Acting as a central liaison ... and development coordination, and special projects + Manage unemployment claims , including timely state responses, documentation gathering, and maintaining accurate… more
- Walgreens (Poughkeepsie, NY)
- …and maintaining front end and pharmacy asset protection techniques, and filing claims for warehouse and vendor overages (merchandise received, but not billed), ... for non-returnable ABC overstock. Verifies posting of all pharmacy/ prescription claims . + Completes execution of all pricing activities including price changes,… more
- Humana (Albany, NY)
- …first** The Encounter Data Management Professional ensures data integrity for claims errors. The Encounter Data Management Professional work assignments are varied ... make an impact** **Required Qualifications** + 1 - 5 years or more of claims processing experience + Minimum of 1 year experience in conducting thorough root cause… more
- Humana (Albany, NY)
- …problems within the encounter process between Humana and CMS using data analysis, claims research, and other resources to provide insight and ensure data integrity ... for Medicare/Medicaid claims errors. **Key Role Functions** + Develop business processes to ensure successful submission and reconciliation of encounter submissions… more
- Northwell Health (New Hyde Park, NY)
- …but considered related are not essential functions. Job Qualification + Associate 's Degree required, or equivalent combination of education and related experience. ... + 3-5 years of relevant experience, required. Preferred Experience + In-depth knowledge of Medicare and Medicaid...Correct Coding Initiative (NCCI) edits and their impact on claims + Ability to analyze large datasets (eg, … more