- Independent Health (Buffalo, NY)
- …daily basis. Assist in interpreting database information as it relates to pharmacy claims processing . + Assist with PBM implementation by identifying potential ... department with various data entry projects/information as they relate to pharmacy claims processing . C. Administrative Duties + Provide accurate and up-to-date… more
- City of New York (New York, NY)
- …VA Claims , Provide Veteran Benefits Counseling: Possess high-level knowledge of processing claims for Veteran benefits from the VA. Trainings and ... the Senior Executive Director will also be a subject matter expert in processing VA claims for Veteran benefits and supervising staff on how to process VA … 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
- Arnot Health (Elmira, NY)
- …assists employees with interpretation and application of Arnot Health benefits (ie claims processing , waiting period, qualifying events, covered expenses) and ... from the employee.* 11. Responsible for the filing of life insurance claims and assisting employees and/or beneficiaries. 12. Communicates with employees, managers,… more
- Humana (Albany, NY)
- …Certifications, CPC, CCS, CFE, AHFI) + Understanding of healthcare industry, claims processing and internal investigative process development + Experience ... it takes to Succeed** + Bachelor's Degree + Minimum of 3 yrs health insurance claims or Medicare experience + Minimum 3 years of experience with Fraud, Waste, and… more
- Humana (Albany, NY)
- …+ 2 years or more of related experience in encounter submissions and claims processing + Demonstrated strong analytical, critical thinking, and problem-solving ... first** The Encounter Data Management Professional ensures data integrity for claims errors. The Encounter Data Management Professional work assignments are varied… more
- Stony Brook University (St. James, NY)
- …systems expertise, patient registration and throughput, health information management, claims processing and reimbursement, payer contracts, and applicable ... third-party systems, including insurance eligibility verification, claim scrubbing, electronic claims submission and remittance, encoder tools, financial analytics platforms,… more
- CVS Health (Amherst, NY)
- …stop loss carrier. **Required Qualifications** *Minimum of 1 year of experience in healthcare claims processing *Minimum of 2 years of experience with the suite ... challenging role provides exposure to virtually all aspects of healthcare claims administration, from reinsurance/stop loss, data analytics, provider and broker… more
- Highmark Health (Albany, NY)
- …+ High school diploma or GED + Experience in pharmacy prescription claims processing /submission/payment. **Preferred** + Associate degree + Pharmacy technician ... medication requests, and drug claim edits/prior authorizations. By reviewing member claims history, clearly defines the medical necessity of non-formulary and prior… more