- FLACRA (Newark, NY)
- …FLACRA's billing and payment collection processes. This position is responsible for processing claims , managing accounts receivable, and ensuring timely and ... outstanding balances. + Work with insurance companies to address disputed claims and resolve processing issues. + Maintain and update tracking spreadsheets for … more
- University of Rochester (Albany, NY)
- …through telephone calls, payer website, and written communication to ensure accurate processing of claims . Collaborate with appropriate departments to generate a ... rejection or denial codes as they pertain to claim processing and coding. Escalates system issues preventing claims... processing and coding. Escalates system issues preventing claims submission and follow-up for review and resolution. +… more
- Sedgwick (Albany, NY)
- …federal/state leave of absence eligibility review; and to ensure the ongoing processing of claims . **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Informs ... within the United States. **PRIMARY PURPOSE** **:** To process claims and determine accommodation options following written guidelines and...claimants of documentation required to process claims , required time frames, and claims status… more
- City of New York (New York, NY)
- …procedures, notices and other customer communications; (d) advising BCS on submitting and processing claims relating to unpaid water and wastewater charges on ... and operations, DEP is party to numerous lawsuits and claims filed with the New York City Comptroller and...the agency in Court and Comptroller personnel who adjust claims against the City. The Litigation Support Counsel will… more
- Healthfirst (NY)
- …+ Experience in clinical practice with experience in appeals & grievances, claims processing , utilization review or utilization management/case management. + ... Demonstrated understanding of Utilization Review Guidelines (NYS ART 44 and 49 PHL), InterQual, Milliman or Medicare local coverage guidelines + Ability to work independently on several computer applications such as Microsoft Word and Excel, as well as… more
- Cognizant (Albany, NY)
- …use Optum PPS configuration. + Demonstrate strong understanding of healthcare claims processing , provider contracts, fee schedules, and benefits configuration. ... + Knowledge of health plan operations for Medicare, Medicaid, Marketplace, LTSS, DSNP (duals) is highly preferred. **Preferred Qualifications:** + Ability to provide advanced analysis, problem-solving, and interpret application configuration. + Excellent… more
- Caterpillar, Inc. (NY)
- …(coverage, forecasting, inventory management, rental fleet utilization, and orders and claims processing , etc.) with special emphasis on streamlining processes ... and improving dealer capability and profitability. + **Expand it** - Identify the potential Market opportunities within Existing and Emerging Markets to expand the Dealers offering to provide full customer solutions including Rental and Used. + **Train it** -… more
- CVS Health (Albany, NY)
- …the creation of AI-driven solutions to optimize healthcare processes, such as claims processing , patient care coordination, pharmacy operations, and supply chain ... management. + Process Optimization: Identify and analyze complex process challenges within CVS Health's operations, defining requirements for AI interventions to enhance efficiency and scalability. Design, prototype, and deploy intelligent systems using… more
- Molina Healthcare (Buffalo, NY)
- …or team leadership experience + 10 years' work experience preferable in claims processing environment and/or healthcare environment + Strong knowledge of ... SQL 2005/2008 SSRS and Power BI report development + Familiar with relational database concepts, and SDLC concepts **Preferred Education** + Masters' Degree in Finance, Economics, Math, Computer Science, Information Systems, or related field. + Preferred… more
- Highmark Health (Albany, NY)
- …analytical and communication skills Preferred + Associate's Degree + 3 years with claims processing and data management + Past auditing and strong ... education/training background in coding and reimbursement **_Disclaimer:_** _The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain… more