- Molina Healthcare (Albany, NY)
- **JOB DESCRIPTION** **Job Summary** The Senior Analyst , Medical Economics provides support and consultation to the Clinical Center of Excellence, Health Plan, ... of healthcare operations (utilization management, disease management, HEDIS quality measures, claims processing , etc.) + Knowledge of healthcare data, including… more
- Molina Healthcare (Albany, NY)
- **JOB DESCRIPTION** **Job Summary** The Senior Analyst , Medical Economics provides support and consultation to the Health Plan and Finance team through analyzing ... of healthcare operations (utilization management, disease management, HEDIS quality measures, claims processing , etc.) + Knowledge of healthcare financial terms… more
- New York State Civil Service (Albany, NY)
- NY HELP No Agency DASNY - Dormitory Authority of the State of New York Title Senior Construction Claims Analyst (Cost Control) - Albany, NY or NYC Office ... and/or construction complexity, environmental issues and other non-traditional project variables. Senior Cost Control Analyst also reviews and provides comments… more
- Mount Sinai Health System (New York, NY)
- …processes, and related regulations. ? Familiarity with contract terms, NYS regulations, claims processing , and healthcare reimbursement models. ? Experience in ... across the Mount Sinai Health System. MSHP seeks a Senior Contract Compliance (Professional Billing) Analyst who...to ensure proper interpretation and application of terms during claims processing . * Ensure that all contract… 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 & ... About the Role We are seeking a passionate, results-oriented Senior Enterprise Business Analyst who can collaborate effectively with internal and external… more
- Highmark Health (Albany, NY)
- …in strategy development for new strategic programs. + Research and analyze claims processing problems, perform initial problem identification and resolution ... (eg non standard tiering) and pricing methods in a senior operational role. Translates complex group and client information...and prepare the specifications necessary to identify impacts to claims processing or other business logic. +… more
- Excellus BlueCross BlueShield (Dewitt, NY)
- …area/out of network non-par claims . In the course of this work, the Analyst will be required to work closely with others to assemble and produce documentation ... with sound and ethical procedures, objectives and controls, a Network Services Analyst analyzes and evaluates the composition and characteristics of Health Plan… more
- Trinity Health (Troy, NY)
- …CVS and/or SPHP based services and external, community-based services) + Assists with processing of Forensic Rape Exam (FRE) reimbursement claims to NYS Office ... Type:** Full time **Shift:** Day Shift **Description:** **Position Summary:** The Project Analyst will assist with programmatic and fiscal reporting for 5-10 grants… more
- Humana (Albany, NY)
- …community and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business Intelligence Engineer will be ... of experience researching MS-DRG, APR-DRG and/or EAPG grouper logic + Experience processing or reviewing facility claims + Prior professional experience… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …you to apply! Job Description: Summary: The Reimbursement Configuration Programmer Analyst is responsible for utilizing system development methodologies to analyze, ... to high level business requirements. The Reimbursement Configuration Programmer Analyst is expected to understand requirements, develop work plans, translate… more