- New York State Civil Service (Albany, NY)
- …Conducts hearings to review and/or decide appeals from agency determinations, claims regarding issues such as eligibility for benefits, discontinuance, denial, ... and binding hearing decisions.* Recommends the acceptance or rejection of claims or compromise settlements according to laws, regulations, policies, and precedent… more
- HUB International (New York, NY)
- …**Key Responsibilities** **:** + Assist in preparing financial reports, claims analyses, cost projections, and benchmarking for mid-market employer groups. ... 4 year college degree in Finance, Business, Economics, Risk Management or related field or equivalent work experience. + 1-2 years prior experience in employee… more
- Ontario ARC (Canandaigua, NY)
- …regulatory standards and run efficiently. In this role, you'll audit billing claims , review Individual Service Plans, conduct site visits, and provide support to ... with their community. Responsibilities + Internal auditing of programs and billing claims to include aspects of compliance with documentation, accuracy of records,… more
- Mount Sinai Health System (New York, NY)
- …Sinai Health System. **Qualifications** + BA or BS degree minimum, in a relevant field of study; Masters degree preferred. + 2 years minimum is preferred in ... knowledge of a health care EMR such as Epic/Clarity, aCW, etc.; a payor claims system such as Facets, Amisys, etc.; or a hospital/provider system such as IDX,… more
- New York State Civil Service (Albany, NY)
- …Representatives at the OAG mediate consumer complaints of fraud, perform field investigations and activities related thereto, and conduct consumer education and ... of health care complaints, including, but not limited to billing and claims reimbursement disputes; denials of coverage for medical treatment, prescriptions, and… more
- New York State Civil Service (Albany, NY)
- …functions or applications using programming languages to perform analyses using commercial claims data.* Develops and maintains reports on commercial health data and ... service delivery and assess network adequacy.* Conducts data analysis (including commercial claims and financial data) to inform the development of programs and… more
- Weill Cornell Medical College (New York, NY)
- …practice management billing system as needed. Tracks and resolves issues on denied claims . Resubmits or appeals claims as required. Escalates more complex claim ... conferences to keep abreast of standards and best practices within the field . Disseminates information to colleagues and/or staff as appropriate. + Provides back-up… more
- KPH Healthcare Services, Inc. (Rochester, NY)
- …and follow-up + Track and re-bill pending Medicaid accounts + Re-bill claims as needed + Identify pattern problems (improper patient demographic data entered, ... accounts for facility and private pay + Month-end closing process + Re-bill claims to improve reimbursement from NETRX reporting + Assist in special projects as… more
- Mount Sinai Health System (New York, NY)
- …in project initiatives. **Qualifications** + BA or BS degree minimum, in a relevant field of study; Masters degree preferred. + 7 years minimum, higher preferred, in ... knowledge of a health care EMR such as Epic/Clarity, eCW, etc.; a payor claims system such as Facets, Amisys, etc.; or a hospital/provider system such as IDX,… more
- City of New York (New York, NY)
- …the Bureau of Revenue Development and Automation unit. - Manage existing revenue claims , including Medicaid and SNAP compliance projects - Aggregate and analyze data ... Data Warehouse, Medicaid Data Warehouse, Passport and other data sources - Develop new claims to maximize revenue - Conduct ad hoc analyses using SQL, Excel, Access… more