- Molina Healthcare (Syracuse, NY)
- …Lead Analyst, Configuration Oversight to support our Payment Integrity and Claims Operations teams in ensuring the accuracy and compliance of Coordination ... and regulatory guidance. The ideal candidate will bring deep knowledge of claims adjudication, QNXT system navigation, and strong analytical acumen. Experience in… more
- Molina Healthcare (Rochester, NY)
- …monitors Health Plan Scorable Action Items (SAIs) to ensure performance and quality levels exist in PI Business products and processes. Establishes procedures and ... execute effective Payment Integrity strategies through both pre-payment and post payment claims reviews, aligning with industry and corporate standards as well as… more
- CDPHP (Albany, NY)
- …member-focused, and community-based not-for-profit health plan that offers high- quality affordable health insurance to members throughout New York. ... The company values people, quality , innovation, and community, and its corporate culture supports...mail sort, batch preparation, and scanning of all incoming claims and correspondence to facilitate and ensure compliance with… more
- Mount Sinai Health System (New York, NY)
- **Job Description** Responsible for ensuring that unpaid and partially paid claims are resolved in an efficient and timely manner. Resolves EOB discrepancies and ... ICD (coding and CCI edits). + Anesthesiology Experience Preferred + Electronic claims processing preferred. **Responsibilities** + Follows up on submitted claims… more
- Molina Healthcare (Buffalo, NY)
- …test approach, strategy for test automation and test analytics, enforcing test quality standards, and providing whole project support and oversight. In addition to ... + SQL expertise + Excel expertise + Medicare, Medicaid, Marketplace claims expertise **PHYSICAL DEMANDS:** Working environment is generally favorable and lighting… more
- City of New York (New York, NY)
- …responsible specialized administrative work supervising the functions of the City-wide Claims Units and/or supervising the functions of the City-wide Special ... Projects Units. The City-wide Claims Units are responsible for...controls of units' performance and activities geared to promote quality of service. Monitor time and leave records for… more
- City of New York (New York, NY)
- …cases. It was enhanced by the addition of the Supplemental Nutrition Assistance Program- Claims and Recovery (SNAP-CR). SNAP-CR establishes SNAP claims for the ... Supervisor, who will: - Directly and indirectly supervise staff in Claims processing/establishment of claims /recovery of manual payments/Program support. Track… more
- University of Rochester (Rochester, NY)
- …to: telephone, photocopy machine, adding machine, personal computer (for claims inquiry and entry software) fax/scanner, Flowcast billing application, Microsoft ... Medicaid Managed Care and Medicare Part B) clearinghouse software, third party claims systems (ePaces, Omnipro) and various payer web sites. **Typical Duties:** 30%… more
- Trinity Health (Albany, NY)
- …After probation period 1 work from home day a week allowed. **Position Highlights:** + Quality of Life: Where career opportunities and quality of life converge + ... required but a plus. **Responsibilities:** + Responsible to monitor and resolve Claims Work queues, Specifically Front End, Referrals & Authorizations, and Clinical… more
- Cardinal Health (Albany, NY)
- …done. **The Accounts Receivable Specialist II is responsible for processing insurance claims and billing. They will work within the scope of responsibilities as ... and support from AR & Billing leadership teams.** **_Responsibilities_** + Processes claims : investigates insurance claims ; and properly resolves by follow-up &… more