- Molina Healthcare (Rochester, NY)
- …pharmacy prior authorization requests and/or appeals. + Explains Point of Sale claims adjudication, state, NCQA, and CMS policy/guidelines, and any other necessary ... and pharmacies. + Assists with clerical services/tasks and other day-to-day operations as delegated. + Effectively communicates plan benefit information, including… more
- AECOM (New York, NY)
- …legal department is actively seeking a creative, highly talented attorney to support AECOM's operations in its East Region. This position will be based in New York ... Work with management and staff to resolve pre-litigation disputes and potential claims + Supervise and manage litigation, including professional liability, breach of… more
- Centene Corporation (Queens, NY)
- …or other higher education in nursing, healthcare administration, business, operations management or other related discipline. Proficiency with healthcare terminology ... ICD 10 codes, medical abbreviations, medications. Experience in medical records review, claims processing or utilization and case management in a clinical practice… more
- Turner & Townsend (New York, NY)
- …projects covering the full spectrum of consultancy, project delivery and post-project operations . With offices located globally, you're never far away from our ... required, facilitate change processes, negotiations, facilitating and negotiation of claims and disputes as required, forecasting, accrual reporting, validation of… more
- Deloitte (Jericho, NY)
- …expertise. We innovate and deliver creative, industry-specific solutions that streamline operations and accelerate speed-to-value. Recruiting for this role ends on ... by reviewing services, contracts, performance guarantees, and renewals. + Analyze claims utilization data and assess health plan performance against strategy. +… more
- KPH Healthcare Services, Inc. (Oneonta, NY)
- …patients. **Responsibilities** + Responsible for assisting with Noble Health Services operations and profitability + Follow all State and Federal guidelines ... with all Noble policies and procedures at all times + Monitors all pharmacy claims for proper reimbursement + Assist in managing the pharmacy inventory. + Assist in… more
- Parsons Corporation (New York, NY)
- …design management, construction management, stakeholder coordination, federal compliance, operations support, office administration, and related services._ Travel to ... ensure proper contract administration, payments certification, variations administration and claims management. + Proactive approach to risk identification and… more
- Parker Hannifin Corporation (Clyde, NY)
- …suppliers and company personnel. + Negotiates and settles damage claims , rejections, losses, return of materials, over-shipments, cancellations and engineering ... principles and concepts. + Knowledge of industry practices, general business operations , and policies. + Knowledge of legal and regulatory requirements related… more
- ASM Global (Buffalo, NY)
- …with a global reach, offering an end-to-end solution across all areas of venue operations and revenue generation for many of the world's most iconic brands and ... process as requested. + Partnership in the processing of worker's compensation claims , leaves of absences, benefits administration. + Develops and facilitates talent… more
- Cushman & Wakefield (New York, NY)
- …C&W's EH&S programs across the US, to ensure safety is part of day-to-day operations at each site within the Asset Services * Effectively communicate C&W's safety ... report and manage the corrective actions * Support Workers Compensation (WC) claims tracking, investigation, and management process * Liaise with WC Program Manager… more