- Brighton Health Plan Solutions, LLC (New York, NY)
- About The Role Brighton Health Plan Solutions (BHPS) is seeking an experienced Claim Dispute Specialist skilled in investigating and resolving provider ... Essential Qualifications + Strong knowledge of contracts, medical terminology, and claim dispute processing and procedures. + Previous experience handling… more
- Molina Healthcare (NY)
- …and prepares written response to incoming provider reconsideration request is relating to claims payment and requests for claim adjustments or to requests from ... + Responsible for the comprehensive research and resolution of the appeals, dispute , grievances, and/or complaints from Molina members, providers and related outside… more
- Independent Health (Buffalo, NY)
- …fosters growth, innovation and collaboration. **Overview** The Clinical & Coding Specialist -Senior will be responsible for reviewing coding and clinical decisions on ... share knowledge and audit tips across the team. The Clinical & Coding Specialist -Senior will support the leadership in Hospital Audit in accomplishing all aspects of… more
- Insight Global (New York, NY)
- …using a data-driven approach. This role will support a large body of work for the Dispute teams back-office operations. The claims agents use Pega Dispute as ... Job Description Insight Global is seeking a specialist in Mastercard or Visa chargeback processes for...is integrated with Mastercard and currently consists of many dispute processing workflows that are manual and require optimization.… more