- Robert Half Finance & Accounting (Dobbs Ferry, NY)
- Description We are looking for a skilled Financial Analyst /Manager to join our team in White Plains, New York. In this role, you will play a pivotal part in ... to identify opportunities for optimization. * Monitor billing, collections, and claims processes to improve revenue flow and address inefficiencies. * Collaborate… more
- Cardinal Health (Albany, NY)
- …data from multiple sources (eg, Salesforce, Trella Insights, Definitive Healthcare, claims feeds, internal CRM/ERP) to deliver clear, actionable insights that ... gaps + Ensure HIPAA/privacy safeguards and appropriate minimum necessary use of PHI/ claims . + Define and operationalize Reach (# of targeted HCPs/accounts touched)… more
- Intermountain Health (Albany, NY)
- …documentation requirements, and reimbursement policies, as well as ensures claims meet medical necessity for procedures performed. **Essential Functions** + ... providers for clarification or additional information when needed. + Submits coded claims to billing department or third-party payers in a timely manner. +… more
- Highmark Health (Albany, NY)
- …Utilize robust, data-driven insights from complex healthcare datasets (eg, claims , clinical, utilization, pharmaceutical) to inform policy development, identify ... 7 years with coding languages, analytical software, systems, tools and processes using claims , clinical, enrollment and provider data + 5 years of project leadership… more
- University of Rochester (Rochester, NY)
- …and datasets related to, but not limited to, enrollment, premiums, claims , payments, prescription rebates, and stop-loss insurance to ensure proper booking ... Maintains several relational data systems and business decision models based on claims and utilization data. + Develops and maintains monthly, quarterly, and annual… more
- Highmark Health (Albany, NY)
- …5 years with coding languages, analytical software, systems, tools and processes using claims , clinical, enrollment and provider data + 3 years of project leadership ... in a complex, matrixed environment (payer and/or provider preferred) + 3 years of providing analytical consultation to clinical, administrative, operational and financial stakeholders **Preferred** + Applied experience analyzing Social Determinants of Health… more
- MVP Health Care (Rochester, NY)
- …other audit activities and manual reviews as requested, ensuring accuracy of claims and supporting overall payment accuracy. + Perform research using "best ... practices" in auditing methodologies, remaining current in CPC coding, reimbursement methodologies, MVP Policies and Procedures, and updates in professional literature. + Contribute to our humble pursuit of excellence by performing various responsibilities… more
- BronxCare Health System (Bronx, NY)
- …collection, analysis, implementation of and compliance with risk management and claims activities, support of and participation in Continuous Quality Improvement ... (CQI) teams, consistent adherence to the specific rules and regulations of the Bronx-Lebanon Hospital Center (a) Safety and Security Policies, (b) Risk Management: Incident and Occurrence Reporting, (c) Infection Control Policies and Procedures and (d) Patient… more
- Bowery Residents Committee (Manhattan, NY)
- …Highly proficient with Microsoft Office tools. + Prior knowledge of electronic claims processing would be preferred. *Vaccination preferred but not required. MAKE AN ... IMPACTAre you looking to make a positive impact on the lives of those in your community? At BRC, our staff help New Yorkers experiencing homelessness reclaim their lives by providing a hand up, offering opportunities for health and self-sufficiency, and… more
- Molina Healthcare (Syracuse, NY)
- …care or payer environment. + In-depth knowledge of medical and hospital claims processing, including CPT/HCPCS, ICD, and modifier usage. + Strong understanding of ... claim system configurations, payment policies, and audit processes. + Exceptional analytical, problem-solving, and documentation skills. + Ability to translate complex business problems into clear system requirements and process improvements. + Proficiency in… more