- Evolent (Albany, NY)
- …: The Coordinator, Intake Utilization Management reports directly to the Manager , Utilization Management. In support of our daily operations this individual ... requesting or submitting prior authorization requests and/or relevant health care experience in claims or appeal & grievances is required. + Ability to read, write… more
- Ross Stores, Inc. (New York, NY)
- …\(HR Connect mailbox\) for the Buying Offices\. + Escalates complex issues to manager , as appropriate\. + Processes bi\-weekly payroll reports from the MyTime hourly ... over\- \(or under\-\) payment in prior paychecks + Responds to and vets unemployment claims with Equifax to ensure accurate management of process\. + Reports on HR… more
- City of New York (New York, NY)
- …act on behalf of the Bureau of Fraud Investigation, Liens and Recovery, Claims and Collections and the Assistance Reimbursement Unit. Their staff review cases, ... teller duties, housing office teller duties, purchasing agent, assistant store manager , sales representative responsible for accounts, or customer service duties or… more
- Guardian Life (New York, NY)
- …implementation of assigned initiatives, influencing cross-functional stakeholders and act as a project manager as needed as the team is lean. **You Will** + Leverage ... + Partner with leaders and key stakeholders across dental network, product, claims , service, finance and other business areas to pressure test recommendations, gain… more
- Centene Corporation (Queens, NY)
- …members to be used for day-to-day purposes and at meetings. + Assist the Manager , as needed, to determine areas that require immediate remediation and assist Fidelis ... ICD 10 codes, medical abbreviations, medications. Experience in medical records review, claims processing or utilization and case management in a clinical practice… more
- City of New York (New York, NY)
- …supported by documentary evidence and appropriate work papers to the Audit Manager /Director of ACS. Prepare and issue audit reports detailing audit testing, ... with significant experience with vendor contract and/or financial auditing, and auditing of claims for payment to assess their validity on a pre or post payment… more
- The Cigna Group (New York, NY)
- …an integral member of the Provider Contracting Team and reports to the Contracting Manager or Market Lead. This role assists and supports the day to day contracting ... of communication with matrix partners including but not limited to, Claims Operations, Medical Management. Credentialing, Legal, Medical Economics, Compliance, Sales… more
- Walmart (Plattsburgh, NY)
- …it. A Walmart Associate Optometrist is the clinical partner to the Vision Center Manager , and core to our mission of advancing eyecare affordably for everyone. About ... aligned with company and regulatory standards for prescriptions and claims , doctor and optician certifications/licensure, and associate training. Guides associates… more
- Walgreens (Brooklyn, NY)
- …rejections. Resolves third-party rejection problems promptly and resubmits rejected claims for payment promptly. Manages and controls Prescription Department ... monitoring one's performance, solicits for constructive feedback, and leverages pharmacy manager as mentor and coach. Maintains current knowledge and skills related… more
- City of New York (New York, NY)
- …Required Experience - Minimum of two years in the capacity of a manager where responsibilities included direct reports in managerial and/or supervisory positions. - ... buy back applications: Military and Previous City/State service. They also process claims for Layoff and Childcare Leave service during membership for certain… more