- New York State Civil Service (Tarrytown, NY)
- …to ensure continued compliance with applicable regulations.* Audit and process contract claims , and approve and review contract payments to ensure that the payments ... are in accordance with the contract terms* Complete site visit to evaluate contracts, and audit to ascertain billing accuracy and compliance * Provide technical assistance related to New York State Laws, rules, regulations and policies on contract… more
- Constructive Partnerships Unlimited (Brooklyn, NY)
- …the code of business conduct, the NYS and federal false claims acts, whistleblower protections and mandatory reporting. Completes corporate compliance training ... at least annually . Fully cooperates in all corporate compliance investigations and reviews. B. Essential Physical Requirements 1. The ability to coordinate the movement of the arms, legs, and torso together in activities where the whole body is in motion,… more
- Community Medical and Dental Care Inc (Monsey, NY)
- …of all professional services rendered. + Prepare and review reports, claims , and correspondence; ensure that records and documentation are compliant with ... Federal and State regulations. + Provide both in-office and telemedicine services to patients. + Prescribe medications and treatments in accordance with state licensure and collaborative practice agreements. + Recommend appropriate physical and dietary… more
- WTW (New York, NY)
- …to day-to-day service issues and questions (eligibility, carrier coverage and claims issues, compliance, etc.) + Preparation for client meetings (prepare agendas ... and materials, coordinate resources, etc.) + Supporting vendor procurement, implementation, and optimization activities + Providing benefit enrollment support, including preparing materials and presentations, verifying policy and plan information, and updating… more
- Brink's (New York, NY)
- …replenishment's, amount loaded versus amount requested, overages/shortages and claims investigation; provide resolution code to reconciliation + Maintain ... and distribute procedures to field personnel, educate field personnel on customer requirements and processes, coordinate and communicate with field personnel to ensure all operational changes are known + Cross train and perform other duties as assigned + Guard… more
- Molina Healthcare (Albany, NY)
- …setting. **Required Experience** + 3 - 5 years customer service, provider service, or claims experience in a managed care setting. + 3-5 years' experience in managed ... healthcare administration and/or Provider Services. + 5 years' experience in provider contract negotiations in a managed healthcare setting ideally in negotiating different provider contract types, ie, physician, group and hospital contracting, etc. + Working… more
- Walgreens (Utica, NY)
- …technology. Finds opportunities to improve productivity + Ensures insurance claims are processed accurately to prevent payment rejections. Resolves patient ... issues by working with insurance companies and medical providers and conducting or participating in third party audits. + Follows-up with medical providers to clarify prescribed medications, dosages, refills, interactions, and allergies to suggest alternative… more
- University of Rochester (Rochester, NY)
- …for non-routine letters of correspondence related to appeals on denied claims , including compiling all necessary information and drafts for provider signature. ... Manages provider(s) documentation and information. Composes and types non-routine correspondence providing factual information. Arranges travel, conference registration, and hotel accommodations. Interfaces with organizations, hospitals, and others to… more
- Community Medical and Dental Care Inc (Monsey, NY)
- …relating to all professional services rendered. + Prepare and review reports, claims , and correspondences. Ensure that records and documentation are in compliance ... with Federal and State regulations. + Provide in-office and telemedicine services to patients. + Prescribe medication and treatment for patients. + Recommend appropriate physical and dietary routines and methods for disease prevention and maintaining personal… more
- Walmart (Auburn, NY)
- …aligned with company and regulatory standards for prescriptions and claims , doctor and optician certifications/licensure, and associate training. Guides associates ... and supports managers on how to address customer and member concerns and merchandise defects. Meets with managers, doctors, and associates to identify and discuss any concerns and issues related to the business and to share information related to new… more