- City of New York (New York, NY)
- …codes from DCAS, DOE, H+H, and non-City payroll entities into the MBF database. - Claims Processing : Review and process Health and Fitness claims in ... or incorrect enrollment documentation. - Payroll Coordination & Auditing: Coordinate the processing of GUL payroll deductions and conduct monthly audits to ensure… more
- Travelers Insurance Company (Melville, NY)
- …us most. As a Claim Rep, you will be responsible for managing, evaluating, and processing claims in a timely and accurate manner. In this detail-oriented and ... guides our customers back to stability. At Travelers, our Claims Organization isn't just a department; it's the beating...role, you will work closely with insureds to ensure claims are resolved efficiently while maintaining a high level… more
- Molina Healthcare (Rochester, NY)
- …of health care operations (utilization management, disease management, HEDIS quality measures, claims processing , etc.) * Knowledge of health care financial ... decision-making. * Mines and manages information from large data sources. * Analyzes claims and other data sources to identify early signs of trends or other… more
- Centene Corporation (New York, NY)
- …IT resources to implement system efficiencies and configuration enhancements to improve claims processing operations. + Apply Coding Guidelines as described in ... to ICD-10 coding changes and its effect on inpatient claims payment. Chart review will include DRG pre-payment review,...adhered to for the appropriate handling of medical necessity, claims denials, and bundling issues. + Provide regular reports… more
- Colgate-Palmolive (New York, NY)
- …Review benefit payments across sources to prevent overpayments and ensure accurate claims processing . Required Qualifications: + Bachelor's degree in Human ... return-to-work dates with HRBPs. Coordination of Workers' Compensation: + Coordinate Claims and Benefits: Integrate Workers' Compensation claims with concurrent… more
- Lakeview Health Services (Geneva, NY)
- …supervision, is responsible for a variety of office/clerical tasks relating to claims processing ; contacting responsible parties to resolve past-due accounts; ... by batch in accordance with established protocol + Submit claims to 3rd party sources of payments + Post...funding continuity and stability + Perform prompt and accurate processing of all bank deposits and transfers + Post… more
- New York State Civil Service (Schenectady, NY)
- …Service Lead, the incumbent will be primarily responsible for correspondence, clerical support, processing claims , and answering phones as a part of the customer ... Prepare all correspondence including approval/denial of various security investigated claims , missing claim documentation, denial of a suspect voucher and… more
- Lumen (Albany, NY)
- …Utilize Vector Databases and Knowledge Graphs to enhance AI applications in underwriting, claims processing , and customer engagement + Develop data pipelines for ... and automation of complex decision-making processes + Apply natural language processing (NLP) techniques to analyze and extract insights from unstructured data… more
- City of New York (New York, NY)
- …systems, employment and work engagement services, revenue-producing computer matches, claims processing systems, and personnel management systems. ITS/Enterprise ... systems development, data telecommunications, database administration, planning of data/information processing , user services, or area networks, at least 18 months… more
- Humana (Albany, NY)
- …Clinical Certifications, CPC, CCS, CFE, AHFI). + Understanding of healthcare industry, claims processing and investigative process development. + Experience in a ... or equivalent work experience + Minimum 2 years of investigative and/or claims experience + Knowledge of healthcare payment methodologies + Strong organizational,… more