- Molina Healthcare (NY)
- …providing business process redesign, communication and change management for operations . Backend operationalization of policies, standardization of system set-up and ... to maintain and/or create business process documentation and workflows related to Core Operations functions. * Serve as liaison between Core Operations and… more
- Veterans Affairs, Veterans Health Administration (Albany, NY)
- …ECFMG certificate, if claimed by the applicant. [If the applicant does not claim an ECFMG certificate, facility officials must still confirm that the medical school ... about the Act and the complaint process, visit Human Resources and Administration/ Operations , Security, and Preparedness (HRA/OSP) at The Fair Chance Act. more
- Mount Sinai Health System (New York, NY)
- …payer policies, contract language, contract negotiations, CMS fee schedule updates, claims submission and appeals, claims adjudication and coverage policies, ... as well as billing/coding changes. 4. Participate in regular operations calls with MSHP, payers to proactively discuss issues that may impact our contracts,… more
- KPH Healthcare Services, Inc. (East Syracuse, NY)
- …to gain efficiencies and improve profitability. + Responsible for monitoring and sending claims via the AWP resubmission tool and analysis reporting of outcomes. + ... training programs. + Assist in the development and preparation of all claims related and profitability reporting. + Responsible for resolving Third Party pharmacy… more
- Excelsior Orthopaedics Group (Amherst, NY)
- …with DMEPOS as directed by a physician. Assists with the efficient operation of the Excelsior Durable Medical Equipment Program. Fits and educates patients ... products used in orthopedic practice. + Knowledge of medical insurance claims procedures and documentation. + Excellent communication, organizational and business… more
- Highmark Health (Albany, NY)
- …gain/risk share contract parameters. This includes analysis and interpretation of claims submission for superior coding accuracy, cost and utilization reports, ... and conflict management + Demonstrates a deep understanding of primary care practice operations and workflow across the continuum of variability in primary care and… more
- Nestle (Holbrook, NY)
- …brokers, export forwarders, ocean carriers, and drayage. + Research and file claims related to damages occurring during international shipping. + Participate in ... to prioritize and juggle multiple demands and workloads, excels in a high-pressure operations environment. **This position will be either a remote or hybrid role… more
- BJs Wholesale Club (Utica, NY)
- …hourly wage increases, hourly promotions, terminations, worker's compensation, and unemployment claims . + Supports club talent acquisition efforts by, among other ... open enrollment process. + Processes LOAs in coordination with LOA Specialist and outside vendor; addresses LOA/WC issues (explaining process, answering questions,… more
- Oak Orchard Health (Brockport, NY)
- …Holidays, and Company paid holidays! Responsible for managing the revenue cycle operations and liaison with the third-party billing organization to ensure proper ... processing of all payer claims . This would include research for accuracy, analyze reports,...par providers. + Manage vendors related with revenue cycle operations . + Manage staff and provide guidance and training,… more
- The Institute for Family Health (New Paltz, NY)
- …Business Development Description SUMMARY: -Hybrid Position- The Revenue Cycle Operations Coordinator is cognizant of the philosophy, standards, objectives and ... Billing and Collections processes including electronic forms of data exchange( claims /ERA/Eligibility). Engaging and team building environment focusing on professional… more