- AON (New York, NY)
- …State and Federal requirements + Analysis of utilization reports, carrier reports, and claims data & trends. + Possess a strong understanding of the health and ... State and Federal requirements + Analysis of utilization reports, carrier reports, and claims data & trends. + Possess a strong understanding of the health and… more
- Zurich NA (Albany, NY)
- …Diploma or Equivalent and 6 or more years of experience in the Claims or Underwriting Support areaOR + Zurich Certified Insurance Apprentice including an Associate ... including an Associate Degree and 4 or more years of experience in the Claims or Underwriting Support areaAND + Knowledge of line/s of business and the legal… more
- Centene Corporation (Queens, NY)
- …+ Educate providers regarding policies and procedures related to referrals and claims submission, web site usage, EDI solicitation and related topics + Perform ... care or medical group experience, provider relations, quality improvement, claims , contracting utilization management, or clinical operations. Project management… more
- New York State Civil Service (Albany, NY)
- …processing and review of 30-day extension requests, Unreasonably Impracticable Claims , Public Convenience and Advantage requests and distance requirement ... processing and review of 30-day extension requests, Unreasonably Impracticable Claims , Public Convenience and Advantage requests and distance requirement… more
- AON (New York, NY)
- …managers and offices of general counsel. + Prepare underwriting submissions and claims exhibits for commercial insurers. + Draft and prepare policy documentation and ... managers and offices of general counsel. + Prepare underwriting submissions and claims exhibits for commercial insurers. + Draft and prepare policy documentation and… more
- Walgreens (Corning, NY)
- …pharmacist, including those to physicians. + Processes (corrects and resubmits) manual claims for third party program prescription services in a timely and efficient ... Maintains knowledge of Company asset protection techniques, and files claims for warehouse overages (merchandise received, but not billed), shortages… more
- OLV Human Services (Lackawanna, NY)
- …+ Ensure the timely and accurate preparation and submission of billing claims and anticipated payments. + Regular communication with payers (insurance companies, ... of monthly revenue, utilization, and accounts receivable reports. + Processing of billing claims as necessary. + Updating of rate and procedure codes as necessary. +… more
- Humana (Albany, NY)
- …problems within the encounter process between Humana and CMS using data analysis, claims research, and other resources to provide insight and ensure data integrity ... for Medicare/Medicaid claims errors. **Key Role Functions** + Develop business processes to ensure successful submission and reconciliation of encounter submissions… more
- AON (Plainview, NY)
- …accounting package. + Prepare premium and profit-sharing remittances and carrier claims salvage payments including Subledger Ledger reconciliation. + Ensure timely ... accounting package. + Prepare premium and profit-sharing remittances and carrier claims salvage payments including Subledger Ledger reconciliation. + Ensure timely… more
- Guidehouse (New York, NY)
- …client business problems, which include but are not limited to medical and pharmacy claims (open and closed), formulary and managed care data, and EMR data. + ... forecast models/ financial models. + Ability to work with large data sets such as claims data. + Excellent attention to detail and ability to review work products of… more