- Centene Corporation (East Syracuse, NY)
- …+ Educate providers regarding policies and procedures related to referrals and claims submission, web site usage, EDI solicitation and related topics + Perform ... care or medical group experience, provider relations, quality improvement, claims , contracting utilization management, or clinical operations. Project management… more
- MTA (Jamaica, NY)
- …section, relative to the existing contract. Provide answers for formal Union claims . Provide input for future labor negotiations. Provide required documentation for ... Claims and Labor Relations. Respond to complaints from other...you require reasonable accommodation for a medical condition or disability to participate in the job application or interview… more
- The Hartford (New York, NY)
- …courses, and other approved educational sources such as CPCU/IIA (CPCU, ARM, Claims ), CIC etc. Industry Specific Knowledge and Safety: Have working knowledge of ... discipline. + Active participation with partnering business units such as underwriting, claims , and sales teams. + Work with Risk Engineering Managing Director on… more
- Independent Health (Buffalo, NY)
- …basis. Assist in interpreting database information as it relates to pharmacy claims processing. + Assist with PBM implementation by identifying potential issues and ... with various data entry projects/information as they relate to pharmacy claims processing. C. Administrative Duties + Provide accurate and up-to-date information… more
- Evolent (Albany, NY)
- …- Payer side, Knowledge of Medicare, Medicaid, Commercial Plans and understanding on claims workflow, members, providers + A minimum of 1 years of experience in ... assurance and database testing, medical benefits, provider, enrollment, and / or claims data. + Demonstrable experience with Testing, Writing Test cases, Test Plans,… more
- Sedgwick (Albany, NY)
- …but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, ... for this or other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The… more
- CGI Technologies and Solutions, Inc. (Albany, NY)
- …determining their annual rent adjustments, reconciling monthly payment requests, processing claims for unpaid rent and damages and extended vacancies. The Business ... contracts; * Perform annual contract rent adjustments; * Evaluate and approve owner's claims for reimbursement due to unpaid rent, tenant damages, and vacancies; *… more
- Sedgwick (Albany, NY)
- …but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, ... for this or other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The… more
- CVS Health (Albany, NY)
- …data, user feedback, and market research to enhance digital self-service, claims transparency, provider search, member portals, and mobile applications. + Identify ... regulated industry. + Strong knowledge of healthcare payer operations ( claims , eligibility, enrollment, prior authorization, provider networks). + Experience working… more
- Evolent (Albany, NY)
- …accounts + Strong knowledge of health plan operations, care/utilization management, claims processing, value-based care, and the levers to optimize financial ... be leveraged to identify opportunities and actions (including EMR, clinical, authorization, claims , SDoH, etc.); understanding of how to translate data and insights… more