- Walmart (Medford, NY)
- …types programs and benefits to current and prospective members processing memberships upgrades and credit accounts encouraging membership renewals participating ... up orders are filled Oversees assigned area of responsibility by handling claims and returns zoning the area arranging and organizing merchandise identifying shrink… more
- CVS Health (New York, NY)
- …mathematical analysis methods, including predictive analytics, natural language processing , reinforcement learning and causal inference with in-depth specialization ... in some areas + Experience working with healthcare data, including claims data, provider data, and / or clinical data + Experience mentoring junior data scientists… more
- Northern Rivers Family Services (Troy, NY)
- …and Medicaid Services (CMS). All electronic prescriptions in NYS require an NPI. Claims processing functions also require the NPI of nurse practitioners and ... physicians. + Federal Drug Enforcement Administration (DEA)number - issued by the United States Department of Justice Department DEA to nurse practitioners and physicians to prescribecontrolledsubstances. DEA registration must be renewed every three years for… more
- Duane Reade (New York, NY)
- …accordance with Walgreens standard operating procedures for entering, third party processing , filling, and dispensing prescriptions. + Assists pharmacists and other ... Maintains knowledge of Company asset protection techniques, and files claims for warehouse overages (merchandise received, but not billed), shortages… more
- Molina Healthcare (Buffalo, NY)
- …**Required Experience** + 3-5 Years of experience with healthcare-related data ( claims /encounters, provider, CMS/EDGE response files, etc. + 3-5 Years of experience ... of programming experience in python to support automated data validation / processing at scale (functions and objects) **PHYSICAL DEMANDS** Working environment is… more
- CDPHP (Albany, NY)
- …two (2) years Utilization Management experience is preferred. + Knowledge of coding/ claims processing is preferred. + Experience working with Microsoft Office, ... including Outlook, Word and Excel, and other databases required. + Demonstrated ability to pro-actively identify problems and recommend solutions. + Demonstrated ability to stay organized and work effectively within strict deadlines. + Demonstrated ability to… more
- City of New York (New York, NY)
- …guidelines. The work of DFS includes managing the ACS budget; submission of monthly claims for revenue; processing of payments to provider agencies and vendors; ... monitoring the financial health of provider agencies through financial review and audits; maintenance of the ACS bank accounts; centralized oversight of ACS Child Welfare financial eligibility; and data maintenance for financial systems of record. The Audit… more
- Molina Healthcare (Buffalo, NY)
- **Job Description** **Job Summary** Responsible for preparation, processing and maintenance of new members and re-enrollment. Processes and maintains health plan's ... rejections. Address a variety of enrollment questions or concerns received via claims , call tracking, or e-mail. Maintain records in the enrollment database.… more
- Insight Global (New York, NY)
- …support a large body of work for the Dispute teams back-office operations. The claims agents use Pega Dispute as their platform to manage credit card disputes and ... parties. Pega is integrated with Mastercard and currently consists of many dispute processing workflows that are manual and require optimization. The goal of this… more
- Trinity Health (Albany, NY)
- …standards and practice workflows: Scheduling and registration Check-in Check-out Charge entry/ claims End of day processes General duties including but not limited ... to: Document processing Scanning Inbox monitoring Complies with Patient Centered Medical Home (PCMH) care delivery model. Performs all mandatory training. Maintains… more