- Molina Healthcare (Albany, NY)
- …credentialing database necessary for processing of recredentialing applications. * Reviews claims payment systems to determine provider status, as necessary. * ... goals. * Reviews and processes daily alerts for federal/state and license sanctions and exclusions reports to determine if providers have sanctions/exclusions.… more
- CVS Health (Albany, NY)
- …members who cannot advocate for themselves. The TOC team will review prior claims to address potential impact on current case management and eligibility status. ... discuss service needs and support safe transitions. **REQUIRED QUALIFICATIONS** - Requires an active license in CT, NY or Compact - 1 year of advanced proficiency in… more
- The Arc Mid-Hudson (Lake Katrine, NY)
- …as the primary liaison with the agency's insurance provider, coordinating accident claims and communications with adjusters, repair shops, and body shops as needed. ... equivalent + A valid New York State Class A, B, or C Commercial Driver's License with a Passenger endorsement + A driving record acceptable to The Arc Mid-Hudson +… more
- KPH Healthcare Services, Inc. (Oneonta, NY)
- …with all Noble policies and procedures at all times + Monitors all pharmacy claims for proper reimbursement + Assist in managing the pharmacy inventory. + Assist in ... Pharmacy Degree from an accredited College of Pharmacy + Current unrestricted Pharmacist license in New York + Obtain and maintain other states licenses as required… more
- ZOLL Medical Corporation (New York, NY)
- …and workflows to achieve operational efficiencies. + Responsible for improved claims billing yield within a defined geography consisting of assigned accounts, ... of working independently with strong self-motivation. + Must have a valid driver's license Knowledge, Skills and Abilities + Ability to proactively plan and work… more
- Walgreens (East Meadow, NY)
- …payment rejections. Resolves third party rejection problems promptly, and resubmits rejected claims for payment on a timely basis. + Manages and controls ... Pharmacy or Pharm D Degree from an accredited educational institute. + Current pharmacist license in the states within the district (or willing to obtain in 1 year)… more
- HUB International (Melville, NY)
- …not limited to, with over 50 lives. **Specific responsibilities include:** + Resolve claims and administrative issues + Act as liaison with insurance carriers and as ... consulting, insurance company, or corporate benefits environment + Valid LA&H License required + Excellent analytical & problem-solving skills + Excellent verbal… more
- Defense Health Agency (Fort Drum, NY)
- …for federal civilian healthcare providers as they are covered by the Federal Tort Claims Act (28 USC | 1346(b)) while acting within the scope of their employment. ... Examination. **Licensure:** Applicants must possess a current, active, full, and unrestricted license or registration as a Physician from a State, the District of… more
- Defense Health Agency (Fort Drum, NY)
- …for federal civilian healthcare providers as they are covered by the Federal Tort Claims Act (28 USC | 1346(b)) while acting within the scope of their employment. ... Examination. **Licensure:** Applicants must possess a current, active, full, and unrestricted license or registration as a Physician from a State, the District of… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …and Federal Mandates. + May be responsible for pricing, coding, researching claims to ensure accurate application of contract benefits and Corporate Medical ... and promotional opportunities. All Levels + Associates degree and active NYS RN license required. Bachelors degree preferred. + Minimum of three years of clinical… more