- Mohawk Valley Health System (Utica, NY)
- …HR. Financial Management: + Oversee billing and coding processes, including insurance claims and patient billing. + Ensure appropriate co-pay and other receivable ... corrective measures when indicated. Technology Integration: + Implement innovative systems to streamline operations, improve patient engagement, and enhance the… more
- BronxCare Health System (Bronx, NY)
- …collection, analysis, implementation of and compliance with risk management and claims activities, support of and participation in Continuous Quality Improvement ... vegetables, fish, meat, casseroles, soups and stews using established food preparation systems and utilizing equipment such as kettles, ovens, deep fryers, and… more
- Mohawk Valley Health System (Utica, NY)
- …patient demographic and insurance information is correct, resulting in accurate claims for reimbursement. Position provides excellent customer service during all ... and documents any and all authorization requirements in appropriate computer systems with relevant information to capture authorization timely. Enters pertinent… more
- BronxCare Health System (Bronx, NY)
- …collection, analysis, implementation of and compliance with risk management and claims activities, support of and participation in Continuous Quality Improvement ... patterns for these services and supervises staff responsible for maintaining these systems . - Establishes information exchange systems between primary care sites… more
- 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
- BronxCare Health System (Bronx, NY)
- …maintaining and furthering a positive public perception of Bronx Care Health System and its employees. - Contributes to and participates in the Performance/Quality ... collection, analysis, implementation of and compliance with risk management and claims activities, support of and participation in Continuous Quality Improvement… more
- EPAM Systems (New York, NY)
- …E2E testing strategies + Develop and communicate test strategies covering pharmacy claims processing, NCPDP transactions, and benefit designs + Design test scenarios ... leading large, complex, cross-functional teams + Extensive knowledge of pharmacy claims adjudication, NCPDP protocols, formulary management, and benefit design +… more
- CVS Health (Albany, NY)
- …and key litigation activities. + Utilizing legal skills to oversee and manage claims against CVS from the initiation of suit through resolution. + Managing all ... identify the litigation strategy in every case assigned. + Creating a plan for claim evaluation to most efficiently resolve or defend cases against CVS while working… more
- BronxCare Health System (Bronx, NY)
- …collection, analysis, implementation of and compliance with risk management and claims activities, support of and participation in Continuous Quality Improvement ... - Bachelor's - Working knowledge of basic office computer systems . Job LocationsUS-NY-Bronx ID2025-5166 Category Management Position Type Regular Full-Time… more
- BronxCare Health System (Bronx, NY)
- …collection, analysis, implementation of and compliance with risk management and claims activities, support of and participation in Continuous Quality Improvement ... regarding CMS, JCAHO, IPRO standards, regulations, monitoring and reporting systems . - Knowledgeable regarding Regulatory Agency Mandates (State and Federal).… more
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