- Sedgwick (Albany, NY)
- …both the client and the reimbursement source **EDUCATION AND LICENSING** RN licensure preferred ; or bachelor's degree in health or human services field required with ... for this or other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The… more
- Molina Healthcare (Albany, NY)
- …models to support analytical and operational use cases, including healthcare claims and utilization data. * Collaborate with cross-functional teams, including data ... warehousing, data validation, data quality checks, metadata management, and governance. ** Preferred Qualifications** * 5+ years of progressive experience in Big Data… more
- WTW (New York, NY)
- …of contact for your clients in all aspects of their insurance program, any claims , wording, coverage or industry news related queries are directed to you, so these ... Submission' document, containing in-depth information about a client's business including claims information, the classes of business needing renewal and any other… more
- Evolent (Albany, NY)
- …You Will Be Doing:** + **Data Analytics & Insights** : Analyze healthcare claims and authorization data to identify cost drivers, utilization trends, and population ... with diverse teams and stakeholders. + Familiarity with healthcare claims , reimbursement methodologies, and cost/utilization KPIs, including prior authorization data… more
- OLV Human Services (Lackawanna, NY)
- …+ Ensure the timely and accurate preparation and submission of billing claims and anticipated payments. + Regular communication with payers (insurance companies, ... of monthly revenue, utilization, and accounts receivable reports. + Processing of billing claims as necessary. + Updating of rate and procedure codes as necessary. +… more
- Walgreens (Corning, NY)
- …pharmacist, including those to physicians. + Processes (corrects and resubmits) manual claims for third party program prescription services in a timely and efficient ... Maintains knowledge of Company asset protection techniques, and files claims for warehouse overages (merchandise received, but not billed), shortages… more
- Robert Half Finance & Accounting (Albany, NY)
- …Responsibilities: * Oversee existing insurance policies to ensure audits, reports, and claims are managed in compliance with New York State regulations. * Assist ... policyholders by addressing claims , providing educational materials, verifying coverage, and delivering proof of insurance. * Identify and pursue new business… more
- Humana (Albany, NY)
- …an impact** **Required Qualifications** + Minimum 1 year of experience in medical claims payment and processing + Minimum 1 year of experience analyzing and ... researching medical claims + Proficient in Microsoft Office (Word, Excel, Access,...+ Familiar with healthcare industry regulations or adjacent sectors ** Preferred Qualifications** + Comprehensive knowledge of Medicare, Medicaid, and… more
- RiseBoro Homecare Inc. (Brooklyn, NY)
- …proceedings. + Support the Risk Manager in tracking insurance-covered litigation matters. File claims with insurance companies for claims and lawsuits as needed. ... Demonstrates integrity and respect in all interactions + Experience with Yardi preferred EDUCATION EXPERIENCE + Bachelor's Degree from and accredited college or… more
- Walgreens (Delhi, NY)
- …pharmacist, including those to physicians. + Processes (corrects and resubmits) manual claims for third party program prescription services in a timely and efficient ... Maintains knowledge of Company asset protection techniques, and files claims for warehouse overages (merchandise received, but not billed), shortages… more