- Molina Healthcare (Buffalo, NY)
- …PPS pricing methodologies. Works closely with IT, the pricing software vendor, operations , health plan representatives, and other business teams involved in claim ... release notes to accurately request and analyze impact reports of affected claims . + Analyzes, interprets, and maintains configurable tables and files that support… more
- Robert Half Finance & Accounting (New York, NY)
- …Your expertise will support the finance department in maintaining efficient operations and accurate reporting. Responsibilities: * Process vendor bills by scanning, ... batch or payout reports. * Investigate and resolve merchant service chargeback claims for wholesale and retail sales. * Process employee reimbursements and record… more
- Trinity Health (Syracuse, NY)
- …thru PeopleSoft. + Schedules meetings. + Assists with missing / damaged belongings claims . + Collects, evaluates, and distributes relevant data. + Other duties as ... Director of Risk Management **SUPERVISES:** None **CAREER PATH:** Administration ** OPERATIONS /COMPLIANCE:** Collaborates with the Risk Analysts, Risk Managers and… more
- Knowledge Builders Inc. (Rensselaer, NY)
- …is not limited to:preparing monthly bureau activity reports; reviewing vendor claims for fiscal and programmatic correctness, adherence to state policy, ... and goals, availability of funds, and appropriateness of rates and submitting those claims for payment; processing and submitting all orders via SFS; managing the… more
- Health Advocates Network (Rensselaer, NY)
- …not limited to: preparing monthly bureau activity reports; reviewing vendor claims for fiscal and programmatic correctness, adherence to state policy, compatibility ... and goals, availability of funds, and appropriateness of rates and submitting those claims for payment; processing and submitting all orders via SFS; managing the… more
- Molina Healthcare (Syracuse, NY)
- …advanced SQL queries to extract, validate, and analyze healthcare data, including claims , authorization, pharmacy, and lab datasets. * Build and maintain efficient ... collaborate cross-functionally to drive data-informed decisions in clinical and business operations . * Maintain fluency in healthcare data types (eg, ICD/CPT codes,… more
- GE Vernova (Schenectady, NY)
- …**What you'll do** **Transactional Support:** + Interface internally with commercial operations and sales providing Risk analysis and solutions in the negotiation ... brokers, and underwriters during negotiations and when needed for negotiating claims in execution. + Obtain and provide Premium estimates for Proposals/Contracts.… more
- Tompkins Community Bank (Batavia, NY)
- …for policy quote and or issuance. + Market and utilize all necessary rating operations sufficient for policy quote and or issuance. + When necessary, meet with the ... protect collection of same. + Assist the Tompkins Insurance claims personnel in and working with the processor in...the processor in the reporting, handling and settlement of claims . + Be familiar with and follow agency E… more
- Sedgwick (Albany, NY)
- …Join a fast-paced, customer-focused team supporting one of the most innovative insurance operations in the industry. As an Inbound Customer Service Agent - Auto ... for this or other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The… more
- Highmark Health (Albany, NY)
- …is a remote based role - looking for someone who has some claims experience and looking to become familiar with risk adjustment.** **ESSENTIAL RESPONSIBILITIES** + ... process improvement meetings and/or discussions. + Analyze the functions and operations of a business area/function and identify problem areas. Create process… more
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