- Highmark Health (Albany, NY)
- **Company :** United Concordia Dental **Job Description :** **JOB SUMMARY** MUST BE A US CITIZEN This position serves as a key liaison between Claims Operations, ... and industry regulatory changes and assess their potential impact on Claims Operations, Customer Service and other operational areas processes and collaborate… more
- Kelly Services (Rochester, NY)
- …permitted by law. Reviews are conducted in accordance with pharmacy management drug policies and procedures. Responsibilities include preparing and interpreting ... cases for Utilization Management (UM) reviews and acting as a content expert...Communicate with pharmacies/physician offices for clarification on requests and claims + Act as lead troubleshooter for pharmacy help… more
- NBC Universal (New York, NY)
- …newly formed media company, Versant Media. Job Duties + Advise and counsel senior management and Human Resources in varied business units with respect to all aspects ... laws (including employment policies, worker classification, discrimination and harassment claims , disability accommodations, and family and medical leave laws,… more
- NBC Universal (New York, NY)
- …development and application, worker classification, reasonable accommodations, workforce management , discrimination and harassment claims , wage-and-hour and ... + Assist with the development of labor strategy and policies + Advise management , Human Resources and other Versant lawyers with respect to all employment and… more
- Otsuka America Pharmaceutical Inc. (Albany, NY)
- …through effective technology transfer, validation, process monitoring, and lifecycle management . This individual will serve as the primary technical steward ... Affairs, and Operations to align strategies and optimize product lifecycle management + Lead root cause investigations for manufacturing deviations and implement… more
- Otsuka America Pharmaceutical Inc. (Albany, NY)
- …(Word, Excel, PowerPoint, Outlook) and familiarity with electronic document management systems (EDMS). **Competencies** See OPDC Competencies Chart (Level X) ... in regulatory affairs or related areas (eg, clinical development, project management , quality assurance, etc.) in pharmaceutical or healthcare related industry.… more
- Excelsior Orthopaedics Group (Amherst, NY)
- …Specialist will be responsible for processing the full lifecycle of medical claims -from charge entry and claim submission to payment posting, denial management ... rejections or denials promptly. + Prepare and submit appeals for denied claims , including documentation and provider narratives as needed. + Identify and report… more
- Elevance Health (Latham, NY)
- …in order to recover corporate and client funds paid on fraudulent claims . Health insurance experience required with understanding of health insurance policies, ... health insurance claims handling and provider network contracting. **How will you...and/or state. + May interface internally with Senior level management and legal department throughout investigative process. + May… more
- Otsuka America Pharmaceutical Inc. (Albany, NY)
- …working with Business Analysis to enhance field intelligence capabilities. + **Compliance Management :** Must comply with all state and federal laws, regulations and ... expertise in business analytics, business operations, sales support, and resource management within a commercial pharmaceutical organization. + Ability to focus on… more
- WMCHealth (Poughkeepsie, NY)
- …link Job Details: Job Summary: The Patient Accounting Clerk processes insurance claims to third party health carriers for billing of medical services provided ... Responsibilities include initial billing, investigation and reconciliation of problem claims , insurance follow up, filing, and other clerical tasks.… more