- 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)
- …team at Humana is essential in delivering core services through effective claims processing and management solutions. This position involves coding software ... applications based on business requirements and addressing moderately complex to complex issues through in-depth analysis. **Responsibilities** + Code software applications that align with business requirements, ensuring high-quality standards. + Standardize… more
- NASCO (Albany, NY)
- …you will tackle moderate to complex technical challenges, enhancing data management and claims processing systems for NASCO and its partners. Collaborating with ... maximize NPS utilization and performance + Researches and resolves production issues so claims can be paid accurately and timely + Explores system capabilities to… 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
- Centene Corporation (Queens, NY)
- …of related experience. Thorough knowledge of customer service, utilization review or claims processing practices in a managed care environment and operation ... or input services in keeping with the prior authorization list. + Research claims inquiry specific to the department and responsibility. + Screen for eligibility and… more
- Brighton Health Plan Solutions, LLC (New York, NY)
- …for top payers across one or more domains (Enrollment & Benefit Administration, Claims processing & Reimbursements, Member & Provider Portals/Service, Clinical & ... Insurance Payer in one of more of the following areas: Claims Administration, Enrollment & Eligibility, Benefit Administration, Contribution Accounting, Billing &… more
- MVP Health Care (Tarrytown, NY)
- …education and complimentary experience preferred. + One year experience in a claims processing , health care/provide office setting or related position required. ... patient charts and other records. + Completes provider payment and invoice tracking/ processing . + Works with MVP Provider Relations Representatives as needed to… 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. ... for accounts receivable processes and daily cash receipts. Accurate and timely processing of billings, receipts, and related payments. Perform analysis of assigned… more
- CDPHP (Albany, NY)
- …a CPT or completion of CPT accredited program. + Experience with pharmacy claims processing , PBM systems, pharmacy billing and payment required. + Experience ... and monitoring the technical aspects of pharmacy benefits including the processing of medical exception requests using approved clinical algorithms, advising on… more
- Molina Healthcare (NY)
- …+ 3-5 years exp in Healthcare Industry + QNXT, Technical Configuration and Claims processing . + Kafka, AKS, Containers, Microsoft technology stack. + AI/ML ... Designs and develop SW applications or systems solving specific business or processing problems (Web or Mobile). + Gathers business requirements and develops… more
Recent Jobs
-
Senior Civil Engineer |
- The Davey Tree Expert Company (Sharon Center, OH)