- Evolent (Albany, NY)
- …who review the appeal, the claims department to review provider post-service claims for medical necessity, and managers for direction and leadership. The ... and accomplishments. **What You Will Be Doing:** Communicates with medical office personnel to obtain pertinent clinical history and...require that all employees have the following technical capability at their home : High speed internet over… more
- CDPHP (Albany, NY)
- …a culture of belonging and takes a wholistic approach to diversity, equity, and inclusion. At CDPHP, the employees have a voice and are encouraged to make an impact ... at both the company and community levels through engagement...Marketing, Enrollment, Pharmacy (internal and external), Provider Services, and Claims Operations to resolve member inquiries as defined within… more
- Rochester Regional Health (Rochester, NY)
- …needed. Coordinate resolution with Customer Service staff. Desired Attributes: + Education/Training: At least one year experience in a Medical Office environment ... is received by RRH for clinical services rendered including professional, long-term/ home care and hospital care, by effectively and accurately managing a… more
- Evolent (Albany, NY)
- …**Technical Requirements:** We require that all employees have the following technical capability at their home : High speed internet over 10 Mbps and, ... the organization and patient health. This role supports both medical cost management activities and business development efforts. **What...employees, the ability to plug in directly to the home internet router. These at - home … more
- Humana (Albany, NY)
- …charity matching program + Network Resource Groups (NRGs) + Career development opportunities **Work- At - Home Requirements** To ensure Home or Hybrid Home ... to work effectively, the self-provided internet service of Home or Hybrid Home /Office employees must meet the following criteria: At minimum, a download… more
- Humana (Albany, NY)
- …subsequently be informed if you will be moving forward to next round of interviews. **Work at Home Guidance** To ensure Home or Hybrid Home /Office ... all business areas such as: Finance, Network, Health Services, Claims and Actuarial **Use your skills to make an...Home /Office associates must meet the following criteria: + At minimum, a download speed of 25 Mbps and… more
- MetLife (Oriskany, NY)
- …for 3-12 weeks. 8:00AM-4:30PM M-F Key Responsibilities: * Virtual roles work from a home office with periodic visits to the assigned GCSO office as needed for team ... continuity, etc. * Handle, review, and administer Family & Medical Leave Act standalone/ADA (as well as other leave)... Leave Act standalone/ADA (as well as other leave) claims and adhere to federal and state regulatory and/or… more
- CenterWell (Albany, NY)
- …Our care teams include nurses, physical therapists, occupational therapists, speech-language pathologists, home health aides, and medical social workers - all ... for the following: clinical and survey metrics, clinical operations metrics, claims denials, AO/state survey results, risk mitigation, clinical compliance, QAPI… more
- Humana (Albany, NY)
- …to work effectively, the self-provided internet service of Home or Hybrid Home /Office employees must meet the following criteria: At minimum, a download ... rethink routine and seek talent with the following attributes + Creative - Adept at research to determine the opportunity and a structured yet flexible approach to… more
- Evolent (Albany, NY)
- …**Technical Requirements:** We require that all employees have the following technical capability at their home : High speed internet over 10 Mbps and, ... Doing:** + **Data Analytics & Insights** : Analyze healthcare claims and authorization data to identify cost drivers, utilization...employees, the ability to plug in directly to the home internet router. These at - home … more