- Molina Healthcare (NY)
- …& ABILITIES** : * 2 - 3 years customer service, provider service, or claims experience in a managed care setting. * Working familiarity with various managed ... healthcare provider compensation methodologies, primarily across Medicaid and Medicare lines of business, including but not limited to, fee-for service, capitation and various forms of risk, ASO, etc. **PREFERRED EDUCATION** : Bachelor's Degree in a related… more
- OLV Human Services (Lackawanna, NY)
- …federal and state regulations and agency policies pertaining to HIPAA, false claims , whistleblower policies and all others. 11. Performs all other job-related duties ... as assigned by supervisor. Skills: * Computer skills * Communication both verbal and written * Ability to learn on the job and change quickly as situations require Hourly Rate: $26.50/hour Minimum Education Required: + Bachelor's Degree Experience: + No… more
- Apicha Community Health Center (Jackson Heights, NY)
- …schedule from PPO/HMO dental plans. + Assist billing department - verify EOBs and claims . + Training - keep an updated list of the dental insurance contact ... information. Qualifications: + High School Diploma or GED equivalent with 2 years of working experience required. Some college education with 1 year of working experience preferred. + Experience in hospital or community health center preferred + Bilingual… more
- City of New York (New York, NY)
- …employment and work engagement services, revenue-producing computer matches, claims processing systems, and personnel management systems. ITS/Enterprise Solutions ... Management is recruiting for one (1) Deputy Commissioner of IT M-IV, to serve as the Assistant Deputy Commissioner, IT Transformation, Application Development, and Operations; This key leadership position will report directly to the Deputy Commissioner of… more
- Cardinal Health (Albany, NY)
- …laws and regulations, (eg, Stark, Corporate Practice of Medicine, Anti-Kickback, False Claims Act, and HIPAA); and Marketing and Advertising + Proactively identify ... and assesses business and legal risks + Demonstrate excellent communication skills and ability to provide business clients with clear and precise guidance on business, compliance, and legal risks + Develop and conduct legal training for business clients + Seek… more
- Centene Corporation (New York, NY)
- …DRG, HCPC reimbursement methodologies. + Documents rate negotiation accurately for proper claims adjudication. + Acts as liaison between the TRICARE beneficiary and ... the provider, facility and the MTF to utilize appropriate and cost effective medical resources within the direct care and purchased care system. + Identifies and refers potential cases to Disease Management, Case Management, Demand Management and Transitional… more
- Molina Healthcare (Buffalo, NY)
- …rejections. Address a variety of enrollment questions or concerns received via claims , call tracking, or e-mail. Maintain records in the enrollment database. ... **Knowledge/Skills/Abilities** + Has direct oversight of enrollment, premium billing and reconciliation processes and all related staff + Coaches and mentors direct staff, including goal setting and score card development + Monitors and enforces compliance… more
- Bassett Healthcare (Cooperstown, NY)
- …inspections Lead weekly construction progress meetings Support change-order evaluation, claims mitigation, and schedule optimization Financial & Risk Management ... Develop detailed project budgets and track expenditures throughout the project lifecycle Lead financial forecasting, develop cash flow statements, review value engineering opportunities, and drive cost control strategies Identify, document, and manage project… more
- Zurich NA (New York, NY)
- …area. OR * Bachelors Degree and 18 or more years of experience in the Claims or Underwriting Support area AND * Experience in a specialized insurance line of ... business or segment (Cargo) Preferred Qualifications: * CPCU *Established Broker partnerships in New York area. * Strong knowledge of underwriting philosophy, techniques, national/local filing regulations and guidelines * Ability to effectively assess risk *… more
- Rallye Motor Company (Westbury, NY)
- …customer or by the warranty. + Work and enter third party tire claims through various electronic applications. Shop Assistant / QC Tech Responsibilities: + Examine ... and test-drive all vehicles to ensure that the cause of vehicle malfunctions and recommend/ perform repairs are completed. Communicate all discrepancies to the Service Manager. + Road test vehicles as required or refer to the inspection technician as… more