- Walgreens (Yonkers, NY)
- …in accordance with state and federal regulations. + Responsible for using pharmacy systems to obtain patient and drug information and process prescriptions. + Models ... Maintains knowledge of Company asset protection techniques, and files claims for warehouse overages (merchandise received, but not billed), shortages… more
- Highmark Health (Albany, NY)
- …**ESSENTIAL RESPONSIBILITIES:** 1. Maintain accurate data in provider file data systems . Common transactions include: + Maintaining and initial setup of assignment ... of experience in Provider Data Management, Credentialing, Customer Services or Claims . **LICENSES OR CERTIFICATIONS** **Required** + None **Preferred** + None… more
- Humana (Albany, NY)
- …record reviews + Assess discharge plans + Review and extract information from claims + Complete documentation for Quality Reviews for Peer Reviews + Discuss cases ... care experience working directly with insurance companies + Use of EMR systems + Additional non-compact nursing licenses + Bilingual is plus **Work-At-Home… more
- Ankura (Lexington, NY)
- …experience. The Ankura team has a mastery of the data and information systems used by providers, payers, and CMS. We combine in-depth operational, compliance, and ... processes, anatomy and pharmacology. + Intermediate to advanced understanding of in claims processing procedures, state and federal regulations, and Medicare Part D… more
- Highmark Health (Albany, NY)
- …(AHFI) **SKILLS** + Must have knowledge of provider facility payment methodology, claims processing systems and coding and billing proficiency + Must ... have understanding of technical and financial aspects of the health insurance industry + Strong personal computer skills, along with the ability to use fraud/abuse data mining tools are required + Must possess excellent communication skills and be detailed… more
- Highmark Health (Buffalo, NY)
- …hospital resources for providers employed in multi-specialty groups or health systems . + For value based contracts addressing government markets, directly ... gain/risk share contract parameters. This includes analysis and interpretation of claims submission for superior coding accuracy, cost and utilization reports,… more
- Tutor Perini (New Rochelle, NY)
- …great nation. We construct and rehabilitate highways, bridges, tunnels, mass-transit systems , and water management and wastewater treatment facilities. In short, we ... complex owner contracts, project cost data, change orders, legal documents and claims revenue recognition in order to determine appropriate accounting positions +… more
- Saia, Inc (Syracuse, NY)
- …within a defined geographic area. Ensures freight is delivered in a claims -free and cost-efficient manner. **Major Tasks and Responsibilities** + Drives tractor ... terminal staff. + Experience using electronic logging devices or other driver technology systems . **Benefits** At Saia, your success is our success! That's why we… more
- IBM (New York, NY)
- …expirations, and re-approvals. * Architect integrations between Veeva Vault and enterprise systems (eg, CRM, RIM, MedComms, DAM) using APIs and middleware. * ... experience with Veeva Vault PromoMats, MedComms, Modular Content, DAM, and Claims modules, with at least two end-to-end PromoMats implementations. * In-depth… more
- Molina Healthcare (Yonkers, NY)
- …member eligibility and covered benefits, Provider Portal, and status of submitted claims . * Ability to effectively communicate in a professionally setting. **Job ... combination of education and experience **PREFERRED EXPERIENCE** : + 1-3 years + Preferred Systems Training: + Microsoft Office + Genesys + Salesforce + Pega + QNXT… more