- Highmark Health (Albany, NY)
- …BE A US CITIZEN This position serves as a key liaison between Claims Operations, Customer Service, Regulatory Affairs, IT, Legal and other departments, proactively ... and industry regulatory changes and assess their potential impact on Claims Operations, Customer Service and other operational areas processes and collaborate… more
- Mount Sinai Health System (New York, NY)
- …billing system and/or payors to facilitate the accurate and timely payment of claims . **Qualifications** + High School diploma/GED. + Three years of experience in a ... medical billing or insurance claims environment. **Responsibilities** 1. Reviews and resolves moderate to...leaders and innovators; and supporting local communities by delivering high- quality care to all who need it. Through the… more
- Norstella (Albany, NY)
- …integrating diverse data sources, including laboratory data, electronic medical records (EMR), claims data, and social determinants of health (SDoH) data, to drive ... goals. + Drive the integration of diverse data sources, including lab, EMR, claims , and SDoH data, to create comprehensive and actionable datasets + Identify and… more
- Leonard Bus Sales, Inc. (Rome, NY)
- …a family-owned dealership and recognized leader in the distribution and support of quality school buses in New York. At Leonard Bus, we provide competitive pay, ... bonus Responsibilities: + Ensures the efficient processing of all warranty claims within company and manufacturer guidelines; ensuring maximum profitability and… more
- MetLife (New York, NY)
- …roadmap for Pet, aligned with business objectives and enterprise data strategy. * Claims automation: Given the exponential growth of the Pet business, claims ... OCR, NLP and LLMs, and building a brand-new ontology for animal health claims . * Governance and data expertise: Establish governance frameworks for data modeling,… more
- Ross Stores, Inc. (New York, NY)
- …Our focus has always been bringing our customers a constant stream of high\- quality brands and on\-trend merchandise at extraordinary savings\. All while providing a ... to promote compliance and mitigate legal exposure, while effectively managing projects/ claims \. The position will report to the Sr\. Director, Employment Law,… more
- New York eHealth Collaborative (New York, NY)
- …present results to both technical and non-technical audiences. + Familiarity with Clinical Quality reporting, Medicare and Medicaid claims data, ICD coding, CDA ... stakeholders. + Design, implement, maintain, and enhance data workflows, quality assurance protocols, analytical processes, and reporting products (eg, dashboards,… more
- Sedgwick (Albany, NY)
- …regulations, and client service requirements and assure efficient, cost effective, quality program delivery for medical and disability management. + Coordinating and ... Pension Board + Review of identified appeal cases for quality assurance purposes + Voting member to determine if...other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating… more
- City of New York (New York, NY)
- …operation of the Office of Audit Services (OAS) and Office of Quality Assurance (OQA), Office of Accountability Strategies (OAS), Compliance and Contract Monitoring ... - Design, test, and implement the process to evaluate claims for skimming reimbursement in a batch, data-driven manner,...and acquire the analytical, data mining, data matching, data quality , and data sharing methods and/or tools that drive… more
- Molina Healthcare (Syracuse, NY)
- …Ability to influence across multiple organizational functions - Payment Integrity, Claims , Encounters, Finance, and Actuarial + Proven experience in managing complex ... implement efficient enterprise-wide processes and governance structures that span claims , encounters, clinical, finance and actuarial functions. + Identifies,… more