- Cognizant (Albany, NY)
- …health monitoring of: Claim adjudication jobs, ASP alerts, CPU alerts, Claims queue monitoring, Storage monitoring, Connect Direct subsystem. + Contact different ... teams if requested by on-call + For application upgrade events, place job queues on HOLD for MOD and Patch instances + Responsible for performing and monitoring all backups on the IBM i Platform. **Required Qualifications:** + 2+ years of IBM i (AS400)… more
- KPH Healthcare Services, Inc. (East Syracuse, NY)
- …the organization's insurance programs, including renewals, coverage adequacy, and claims oversight. **This is not a remote opportunity** **Responsibilities** **Job ... Duties:** + Act as a strategic partner to the CFO and other key stakeholders by providing expert analysis and insights to drive decision-making and operational efficiencies. + Responsible for leading and managing all aspects of company-wide financial planning,… more
- Acosta Group (Vestal, NY)
- …to perform the essential duties. _Responsibilities With Regard to Workers' Compensation Claims :_ You are responsible for reporting all employment related injury you ... incur to your direct supervisor as soon as possible following an incident resulting in an injury. **QUALIFICATIONS** _Education/Experience:_ High school diploma or general education degree (GED); or one to three months' related experience and/or training; or… more
- Constructive Partnerships Unlimited (Queens, 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. SUPERVISES: Direct Care Counselor (approximately twenty-five (25) staff) more
- IQVIA (New York, NY)
- …sales and/or account management or consulting experience. + Experience with medical claims and data analytics is required. + Possesses knowledge of key marketplace ... issues for the pharmaceutical and biotech industry. **Additional Requirements:** + Excellent interpersonal and collaboration skills and the ability to work effectively with others in and across the organization to accomplish team goals + Must have superior and… more
- Humana (Albany, NY)
- …coverage + Experience in negotiation + Experience working with healthcare or claims related data **Additional Information** **Work At Home / Internet Information:** ... To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: + At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps… more
- New York State Civil Service (Albany, NY)
- …and entitlement criteria to veterans and/or their families; the analysis of claims for veteran benefits; the preparation of rating decisions; and/or the direction ... and conduct of post-decisional hearings and processes appeals for veterans and/or their families. Substitution: College credits may be substituted for up to two years for the required experience at the rate of 30 semester credit hours equaling one year of… more
- Humana (Albany, NY)
- …and Lucid. **Preferred Qualifications** + Minimum 1 year of experience medical claims payment and processing in a medical claim's environment + Experience creating ... pivot tables and consumable information within Excel + Knowledgeable in regulations governing health care industries or related adjacent industries **Additional Information** **Work-At-Home Requirements:** + WAH requirements: Must have the ability to provide a… more
- TEKsystems (New York, NY)
- …limited to, medical record review for missed opportunities and provider chase leads, claims research, and chase activation. + Complete training and testing in the ... required timeframe with a satisfactory pass rate. + Communicate and collaborate with coworkers, team leads and manager. + Follow HIPAA and company guidelines to safeguard PHI and PII + Utilize company equipment in a private, secured, at home location using… more
- Evolent (Albany, NY)
- …as HIPAA, as well as healthcare systems and domains (FHIR/HL7, EMR/EHR, Claims , Members, Providers, Payors, etc.). + Experience with designing and implementing ... well-thought-out APIs in a service-oriented architecture. + Strong problem-solving, communication, and organizational skills. Ability to work effectively in a team-oriented environment. **To comply with HIPAA security standards (45 CFR sec. 164.308 (a) (3)),… more