- Elevance Health (Latham, NY)
- …of reimbursement, as applicable. + Assists in problem solving with providers, claims or service issues. + Assists with development of utilization/care management ... that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our… more
- Walgreens (Fayetteville, NY)
- …rejections. Resolves third-party rejection problems promptly and resubmits rejected claims for payment promptly. + Manages and controls Prescription Department ... drive business growth. + Recommends, plans, and administers community and professional relations programs. + Informs appropriate personnel of department's plans,… more
- Elevance Health (Latham, NY)
- …and models data including risk reporting and forecasting. + Calculates monthly claims liability reserves, develops merit rating factors and prepares Department of ... that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our… more
- Defense Health Agency (Fort Drum, NY)
- …for federal civilian healthcare providers as they are covered by the Federal Tort Claims Act (28 USC | 1346(b)) while acting within the scope of their employment. ... programs (eg, Peace Corps, AmeriCorps) and other organizations (eg, professional ; philanthropic; religious; spiritual; community; student; social). You will receive… more
- Albany Medical Center (Albany, NY)
- …analyze and discuss business plans and profitability analysis for lab ventures. PROFESSIONAL SKILLS: Ability to: Analyze, design and implement complex systems that ... for change and implement as indicated. Integrate customer needs, intended use claims , and regulatory requirements into development of design goals. Develop and… more
- Molina Healthcare (Rochester, NY)
- …abuse, and over utilization by providers and recipients. The position will review claims data, medical records, and billing data from all types of healthcare ... Energetic and forward thinking with high ethical standards and a professional image + Collaborative and team-oriented + Required License, Certification, Association… more
- Gilead Sciences, Inc. (Brooklyn, NY)
- …presentation skills, and ability to influence others to represent Gilead at professional events and promote company products * Partner with Medical Scientists, ... and Drug Administration's implementing regulations, the Federal Anti-Kickback Statute, the False Claims Act, PhRMA, Corporate Code of Business Conduct and the Office… more
- The Hartford (New York, NY)
- …product diversification. We write assumed treaty reinsurance for Property, Casualty, Professional Liability, Group Life and Benefits (focused in Latin America), ... position, the individual will collaborate with underwriting, reserving, and claims counterparts to project expected profitability, evaluate returns for individual… more
- Constructive Partnerships Unlimited (Bronx, NY)
- …the code of business conduct, the NYS and federal false claims acts, whistleblower protections and mandatory reporting. Completes corporate compliance training ... and tuition assistance programs. CP Unlimited also provides a very generous time off package, which includes vacation, personal, sick, professional and holiday days. more
- Cardinal Health (Albany, NY)
- …the interpretation and application of relevant laws (eg, Anti-Kickback, False Claims Act, HIPAA, Antitrust) + Demonstrate excellent communication skills and ability ... on current regulations, cases, trends and best practices + Communicate in a professional and persuasive manner with appropriate support for legal advice + Work… more