- Centene Corporation (New York, NY)
- …to providers that would improve utilization and health care quality. + Review claims involving complex, controversial, or unusual or new services in order to ... treating or managing care for a culturally diverse population preferred. **License/ Certification :** Board certification in a medical specialty recognized by… more
- Molina Healthcare (Syracuse, NY)
- …with AI Data Integration._** + **_Experience with Member, Enrollment, and Claims applications -_** **which underpin essential business functions such as HEDIS ... Databricks._** + **_Python._** + **_Spark._** + **_QNXT._** **Preferred License, Certification , Association** Microsoft Technology, Mobility, ITIL To all current… more
- The Institute for Family Health (New Paltz, NY)
- …and facilitates resolution. + May be responsible for Claim Printing/Reviewing of printed claim forms for accuracy to ensure claims are paid timely. + May be ... Development Description Plus, Differentials (Up to 10 Years Experience, Education, Certification ) SUMMARY: The Revenue Cycle Operations Coordinator is cognizant of… 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 ... services for NYC uninsured and under insured residents. Reporting to the Assistant Director of Patient Billing by working alongside a team of talented health… more
- City of New York (New York, NY)
- …to the Bureau's Claim Prepares used to track and identify all claims submitted for reimbursement. - Assist with the management of the distribution of scanned ... is critical to tracking and cataloging of all BCR claims , as well as the submission of all DSS...as a digital reference. - Prepare claiming folders for certification and executive signature approval for all programmatic, administrative,… more
- University of Buffalo - Campus, Dining (Buffalo, NY)
- …and Leave Administrator Reports to Benefits and Leave Manager/Human Resource Director Department Human Resources FLSA Status Full-Time, Exempt Salaried Position ... handbooks. workers compensation benefits, and safety programs and unemployment claims . This role reports directly to the Benefits and...Manager and this department reports to the Human Resource Director . Expected Hours of Work This is a full… more
- Stony Brook University (Commack, NY)
- …Care Provider Enrollment Specialist, you will work under the oversight of the Director of Managed Care Enrollment and join a team of professionals representing Stony ... are to be enrolled within ninety (60) days of roster submission. Inform Director of Enrollment of MCOs non-compliance. A provider enrollment roster should be sent,… more
- WMCHealth (Valhalla, NY)
- …for specialty medications, tracking expiring authorizations and renewals + Review claims and rejections to determine required follow-up, ensuring timely resolution ... continuity of care + Manage daily billing operations, including submission of claims and coordination with prior authorization technicians as needed + Process… more
- Army National Guard Units (Latham, NY)
- …days in a calendar year must be approved in advance by the National Guard, Director of Manpower and Personnel (NGB-J1). - Certification Level 2: THIS IS A ... provide a copy of Official Transcripts as documentation to support your educational claims . To receive credit for Education, you must provide documentation of proof… more
- Independent Health (Buffalo, NY)
- …Specialist (CCDS), American Health Information Management Association (CCS-H, CCS-P), Certification Denials and Appeals Management (C-DAM), or NYS licensed RN ... skills. Ability to ensure that clinical information translates correctly into claim coding compliance with requested data set. Ability to prepare quantitative… more