- Molina Healthcare (Syracuse, NY)
- …or team leadership experience + 10 years' work experience preferable in claims processing environment and/or healthcare environment + Strong knowledge of ... SQL 2005/2008 SSRS report development + Familiar with relational database concepts, and SDLC concepts **Preferred Education** Masters' Degree in Finance, Economics, Math, Computer Science, Information Systems, or related field. **Preferred Experience** 3 - 5… more
- Molina Healthcare (Yonkers, NY)
- …health care operations (utilization management, disease management, HEDIS quality measures, claims processing , etc.) * Advanced understanding on health care ... financial terms (eg, PMPM, revenue) and different standard code systems (ICD-10CM, CPT, HCPCS, NDC, etc.) utilized in medical coding/billing (UB04/1500 form). * Advanced understanding of key managed care concepts and provider reimbursement principles such as… more
- Rochester Regional Health (Rochester, NY)
- …Responsibilities Responsibilities will include basic knowledge of medical billing, medical claims processing and accounts receivable collections. The Medical ... collection specialist must have the Ability to learn and understand medical billing protocol and reimbursement issues, work within Meditech and Emdeon to identify denial trends as well as be responsible for locating and monitoring overdue third party accounts… more
- CDPHP (Latham, NY)
- …review health care delivery against established criteria required. + Understanding of coding/ claims processing is preferred. + Ability to communicate effectively ... with members with varying levels of education, health literacy and understanding. + Demonstrated ability to interact with provider, members to positively impact the quality of patient care required. + Proven customer service skills. + Foster teamwork as an… more
- Humana (Albany, NY)
- …Clinical Certifications, CPC, CCS, CFE, AHFI). + Understanding of healthcare industry, claims processing and investigative process development. + Experience in a ... corporate environment and understanding of business operations **Additional Information** **Work at Home Requirements** * At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is… more
- Air National Guard Units (Syracuse, NY)
- …education, and/or training that has provided a basic knowledge of data processing functions and general management principles that enabled the applicant to ... provide a copy of Official Transcripts as documentation to support your educational claims . To receive credit for Education, you must provide documentation of proof… more
- SMBC (White Plains, NY)
- …Pre-settlement payment affirmation and post-settlement investigations inclusive of compensation claims processing . + Risk mitigation discipline + Identification ... and escalation of settlement breaks as needed. + Understand and ensure compliance with relevant regulatory requirements. + Proficiency using various industry-standard settlement platforms as well as the firm's proprietary systems. + Identify opportunities for… more
- 32BJ Benefit Funds (New York, NY)
- …knowledge base of healthcare industry and medical terminology + Insurance/managed care and claims processing background a plus. Work Hours: 35 Total (Available ... shifts Monday-Friday 9:00am-5:00pm) Work Hours: 35 Total (Available shifts Monday-Friday 9:00am-5:00pm) more
- Elderwood (Williamsville, NY)
- …Order name badges, business cards and computer access as needed.17. Timely processing of employee termination and maintain staff roster in several databases.18. ... work expectations. Unemployment & Workers Compensation28. Ensure timely response to claims for unemployment insurance. Verify that all termination data isreported to… more
- City of New York (New York, NY)
- …responsible for managing payments for over 500 active contracts. - Direct the processing of approximately 30,000 Medicaid reimbursement claims per month, related ... to a class-action settlement. - Develop and enforce accounting policies, internal controls, and financial reporting systems within FMS to ensure compliance and efficiency. - Verify expenditures and program eligibility through the Passport system and close… more