- Molina Healthcare (Syracuse, NY)
- …and executing operational initiatives tied to Payment Integrity (PI) and provider claims accuracy. The individual will be relied upon to make independent, informed ... SAI targets are met. + Leads efforts to improve claim payment accuracy and financial performance without needing extensive...a business lens to ensure accurate interpretation of provider claims trends, payment integrity issues, and process gaps. +… more
- MTA (New York, NY)
- Vice President Project Controls Executive ( Systems ) Job ID: 10850 Business Unit: MTA Construction & Development Location: New York, NY, United States ... Regular/Temporary: Regular Department: Systems -C&D Date Posted: May 10, 2025 Description This position...escalated items related to cost estimates, schedules, change orders, claims , time extension requests, and disputes. Evaluate actual project… more
- CVS Health (Albany, NY)
- …a highly skilled and experienced Senior Product Owner to join our Commercial Claim Adjudication engineering team. As a Senior Product Owner, you will contribute to ... product strategy by: + Leading the development and enhancement of Commercial Claim products or services. + Conducting market research. + Collaborating with… more
- BronxCare Health System (Bronx, NY)
- …with maintaining and furthering a positive public perception of BronxCare Health System and its employees. - Contributes to and participates in the ... collection, analysis, implementation of and compliance with risk management and claims activities, support of and participation in Continuous Quality Improvement… more
- BronxCare Health System (Bronx, NY)
- …with maintaining and furthering a positive public perception of BronxCare Health System and its employees. - Contributes to and participates in the ... collection, analysis, implementation of and compliance with risk management and claims activities, support of and participation in Continuous Quality Improvement… more
- MVP Health Care (Schenectady, NY)
- …in every interaction **Your key responsibilities:** + Perform continuous data entry of claim forms into internal systems from electronic images and paper ... Rochester, NY + 1-2 years of data entry or claims experience preferred. High accuracy and attention to detail....Load new providers and maintain existing provider records in systems such as Facets and Macess. + Ensure compliance… more
- CVS Health (Albany, NY)
- …+ Clinical background a plus. + Experience with Aetna and CVS products, claim systems , and digital member applications. + Associate degree or equivalent ... clinical support to members as well as navigating them through the health system , providing support on claims issues, and answering coverage-level questions.… more
- WMCHealth (Kingston, NY)
- …+ Analyzes daily electronic billing reports for errors. Performs daily reconciliation of claim submission and receipt. Ensures that rejected claims are corrected ... Applicant link Job Details: To submit and/or follow-up on all claims for HealthAlliance for multiple payors. Responsibilities: + Demonstrates proven abilities… more
- WMCHealth (Kingston, NY)
- …+ Analyzes daily electronic billing reports for errors. Performs daily reconciliation of claim submission and receipt. Ensures that rejected claims are corrected ... Applicant link Job Details: To submit and/or follow-up on all claims for HealthAlliance for multiple payors. RESPONSIBILITIES + Demonstrates proven abilities… more
- Spectrum Health and Human Services (Orchard Park, NY)
- …a bi-weekly basis generating claim batches. Basic level and low volume of claims . + Accurately edits claims for successful submission and payment + Submits ... and payer related activity in the electronic health record system . MAJOR DUTIES AND RESPONSIBILITIES: + Performs authorization verification...Medicaid and 3rd Party Payer claims on a minimum of… more