- City of New York (New York, NY)
- …guidelines. The work of DFS includes managing the ACS budget; submission of monthly claims for revenue; processing of payments to provider agencies and vendors; ... children and families served by ACS. The Human Services Payments unit's scope includes processing payments to 94 vendors on more than 300 contracts through the MOCS… more
- Molina Healthcare (Syracuse, 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 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 Experience** 3 - 5… more
- Molina Healthcare (Yonkers, NY)
- …health care operations (utilization management, disease management, HEDIS quality measures, claims processing , etc.) * Advanced understanding on health care ... financial terms (eg, PMPM, revenue) and different standard code systems (ICD-10CM, CPT, HCPCS, NDC, etc.) utilized in medical coding/billing (UB04/1500 form). * Advanced understanding of key managed care concepts and provider reimbursement principles such as… more
- Rochester Regional Health (Rochester, NY)
- …Responsibilities Responsibilities will include basic knowledge of medical billing, medical claims processing and accounts receivable collections. The Medical ... collection specialist must have the Ability to learn and understand medical billing protocol and reimbursement issues, work within Meditech and Emdeon to identify denial trends as well as be responsible for locating and monitoring overdue third party accounts… more
- CDPHP (Latham, NY)
- …review health care delivery against established criteria required. + Understanding of coding/ claims processing is preferred. + Ability to communicate effectively ... with members with varying levels of education, health literacy and understanding. + Demonstrated ability to interact with provider, members to positively impact the quality of patient care required. + Proven customer service skills. + Foster teamwork as an… more
- Humana (Albany, NY)
- …Clinical Certifications, CPC, CCS, CFE, AHFI). + Understanding of healthcare industry, claims processing and investigative process development. + Experience in a ... corporate environment and understanding of business operations **Additional Information** **Work at Home Requirements** * At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is… more
- SMBC (White Plains, NY)
- …Pre-settlement payment affirmation and post-settlement investigations inclusive of compensation claims processing . + Risk mitigation discipline + Identification ... and escalation of settlement breaks as needed. + Understand and ensure compliance with relevant regulatory requirements. + Proficiency using various industry-standard settlement platforms as well as the firm's proprietary systems. + Identify opportunities for… more
- 32BJ Benefit Funds (New York, NY)
- …knowledge base of healthcare industry and medical terminology + Insurance/managed care and claims processing background a plus. Work Hours: 35 Total (Available ... shifts Monday-Friday 9:00am-5:00pm) Work Hours: 35 Total (Available shifts Monday-Friday 9:00am-5:00pm) more
- Humana (Albany, NY)
- …and processes + Solid understanding of healthcare operations, particularly around claims processing , enrollment, provider data management and clinical ... operations; Medicaid preferred + Comprehensive understanding of a Medicaid Managed Care architecture, tools, utilities and processes utilized to deliver on core competences + Delivery focused - time, scope, quality + In-depth knowledge of Medicaid regulations,… more
- Trinity Health (Troy, NY)
- …organization or other health care financial service setting, performing medical claims processing , financial counseling, financial clearance, accounting or ... customer service activities. + Consideration may be given for commensurate customer service experience in another industry. + Knowledge of insurance and governmental programs, regulations and billing processes (Medicare, Medicaid, Social Security Disability,… more