- Stony Brook University (East Setauket, NY)
- Senior Revenue Cycle Specialist **Position Summary:** At Stony Brook Medicine, the ** Senior Revenue Cycle Specialist ** will act as an operational leader ... but are not limited to:** + Develops staff work listing logic/strategy and claims resolution work flows. + Educates and trains new staff regarding departmental and… more
- CVS Health (Albany, NY)
- …do it all with heart, each and every day. **Position Summary** The ** Senior Accounts Receivable Specialist ** prepares accounting and financial records and ... in accounting system. + Enter and process monthly fee claims for ancillary product offerings via claim ...fee claims for ancillary product offerings via claim system. **Required Qualifications** + 2+ years of experience… more
- Staffing Solutions Organization (Albany, NY)
- …workforce, which is a reflection of our clients and the people they serve. ** Senior Healthcare Program Specialist (Level 2 or 3) - Albany, NY** **Division ... the necessary determination regarding when and how to update eligibility and claims systems. + Take the appropriate actions regarding Medicaid enrollment and premium… more
- Nestle (New York, NY)
- …best-in-class opportunities for your development and growth. Join us! **POSITION OVERVIEW:** The Senior Safety & Health Specialist will work towards zero unsafe ... as all applicable external regulatory requirements. + Initiates WC Claims to insurance provider. + Ensure all locations have...locations have preferred HCP locations. + Follow up on Claims as required. + Partners with Human Resources and… more
- CRC Insurance Services, Inc. (NY)
- …and makes recommendation for additional activity as appropriate. 3. Determine where new loss claims should be reported. 4. Manage all claim documentation. 5. Use ... information and/or correspondence to the Agent or Insurer to process claims appropriately. 6. Analyze claim coverage with insurance carriers to ensure claims … more
- CVS Health (Albany, NY)
- …measuring and monitoring the quality and effectiveness of work processes in claim processing and customer service that impact customer satisfaction, medical cost ... both routine and non-routine business support tasks for the Sr Quality Specialist area under limited supervision, referring deviations from standard practices to… more
- CVS Health (Albany, NY)
- …handle customer service inquiries and problems. **Additional Responsibilities:** Reviews pre-specified claims or claims that exceed specialist adjudication ... day. **Position Summary** Reviews and adjudicates complex, sensitive, and/or specialized claims in accordance with plan processing guidelines. Acts as a subject… more
- CVS Health (Albany, NY)
- …Reinsurance, and/or RX claims ; adjudicates complex, sensitive, and/or specialized claims in accordance with claim processing guidelines. Process provider ... amount level on customer service platforms by using technical and claims processing expertise. + Applies medical necessity guidelines, determine coverage, complete… more
- KPH Healthcare Services, Inc. (Gouverneur, NY)
- …With Us! (https://kphcareers-kphhealthcareservices.icims.com/jobs/14032/ senior -benefit-operations- specialist ... act as a lead role within the Benefit Operations Specialist team and be a liaison to management and...**Experience:** + Required: 1 year experience using the RxIQ claims adjudication platform + Preferred: 2 Years experience with… more
- Axis (New York, NY)
- …of claim and to make recommendation regarding settlement/disposition of claims . The candidate's key duties and responsibilities include, but are not limited ... scope of claim and to guide strategic direction regardingsettlement/disposition of claims + Timely evaluation, reserving and disposition of assigned claims … more