- Molina Healthcare (Syracuse, NY)
- …information on all claims and provider databases. Synchronizes data among multiple claims systems and application of business rules as they apply to each ... that provider information is loaded accurately to allow for proper claims processing, outbound reporting and directory processes. **JOB QUALIFICATIONS** **Required… more
- Molina Healthcare (Yonkers, NY)
- …Maintains critical information on claims databases. Synchronizes data among operational and claims systems and application of business rules as they apply to ... or reference table information into the claim payment system and other applicable systems . + Participates in defect resolution for assigned component + Assists with… more
- Molina Healthcare (New York, NY)
- …Maintains critical information on claims databases. Synchronizes data among operational and claims systems and application of business rules as they apply to ... or reference table information into the claim payment system and other applicable systems . + Participates in defect resolution for assigned component + Assists with… more
- Brighton Health Plan Solutions, LLC (New York, NY)
- …work streams, including: Client Implementation, Enrollment & Eligibility, Claims processing & Reimbursements, Member/Provider self-service, Customer Service, Legal ... resource planning. + Manage various file integrations including eligibility, accumulators, claims , etc. + Create an efficient process to manage client… more
- The Cigna Group (Albany, NY)
- **Position Summary:** We are seeking an experienced Scrum Master to join our Claims Systems Operations team. This role is pivotal in fostering a collaborative, ... high-performing environment that supports the delivery of valuable claims system solutions. The Scrum Master will uphold SAFe framework values, facilitate team… more
- Beacon Mobility (Beacon, NY)
- …the fleet department and telematics + Manage the device RMA process, warranty claims + Manage non-reporting devices for quick resolution and minimize device downtime ... information + Oversee installation partners and installation progress of telematics systems + Manage system accessibility for all Beacon employees, drivers, etc.… more
- Highmark Health (Albany, NY)
- …scope and complexity + 5 years with coding languages, analytical software, systems , tools and processes using claims , clinical, enrollment and provider ... data + 3 years of project leadership in a complex, matrixed environment (payer and/or provider preferred) + 3 years of providing analytical consultation to clinical, administrative, operational and financial stakeholders **Preferred** + None **LICENSES or… more
- CVS Health (Albany, NY)
- …+ Market and place stop loss policies, negotiating terms based upon claims data, strategy, relationships and cost avoidance/reduction efforts. + Work with leaders ... of the Meritain products and services along with strong business and systems knowledge. + Reviews work for accuracy and recommends pricing and/or accounting… more
- CVS Health (Amherst, NY)
- …the appropriate customers/accounts + Balance deposits in the accounting system + Follow systems of checks and balances + Allocate Broker commissions for payment + ... monthly invoices in accounting system + Enter and process monthly fee claims for ancillary product offerings via claim system **Required Qualifications-** + 6+… more
- City of New York (New York, NY)
- …programs in more efficient/effective approaches to program administration. - Utilizes automated systems and tools to support public health research and analysis to ... ensure claims submitted to the Grantors are accurate and timely. - Maintain research cost records submitted by programs, writes reports and prepares and conducts… more
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