- Independent Health (Buffalo, NY)
- …+ Bachelor's degree required in Mathematics, Statistics, Actuarial Sciences, or related field . Master's degree preferred. ASA designation preferred. + Five (5) years ... testing to assess impacts on pricing outcomes. + Establish and implement claims review processes to support risk adjustment. Analyze data and provide strategic… more
- University of Rochester (Rochester, NY)
- …to acquire necessary information and assembly of documentation necessary to submit claims to the patient's insurance for approval including prior authorization and ... completion of required patient documentation. Coordinate required information for denied claims . Participate in payer audits and collect, summarize and send… more
- City of New York (New York, NY)
- …materials; managing all grant-related activities including expenditures; deliverables, fiscal claims , evaluations, and reporting; and providing guidance to partner ... providing progress reports to the State; handling program audits; and ensuring participating agency claims are paid in a timely manner. The Director will also act as… more
- Mount Sinai Health System (New York, NY)
- …+ Bachelor?s degree in Business, Finance, Healthcare Administration, or a related field . + Additional certifications (eg, CPC, CCS, or related healthcare coding ... + In-depth knowledge of healthcare revenue cycle processes, including billing, claims management, and payment reconciliation. + Familiarity with **Stratajazz** ,… more
- Norstella (Albany, NY)
- …to extract meaningful insights from real-world data (RWD) sources, including claims , laboratory results, billing codes, and electronic health records (EHRs). You ... Epidemiology, Public Health, Pharmacy (PharmD), Medicine (MD/DO), or a related field . + Experience working with and querying large healthcare databases, including… more
- WMCHealth (Kingston, NY)
- …Applicant link Job Details: Coordinates the orderly processing of all third party claims in accordance with the policies and procedures of the nursing home and ... accurate cash receipt and Ancillary Services posting to the Accounts Receivable system.Submits claims for third party insurance payers. Handles self pay billing in a… more
- Molina Healthcare (Yonkers, NY)
- …responsible for the holistic management of the external vendor relationships for Claims and Enrollment activities (along with other Core Ops areas of ... and benefit realization + Demonstrates deep understanding of Core Operations, Claims and Enrollment processes, deliverables, vendor partners and technology platforms… more
- Humana (Albany, NY)
- …Qualifications** + Bachelor's Degree in Actuarial Science, Mathematics, Statistics, or related field + ASA or FSA designation, MAAA + 2+ years of actuarial ... experience in health insurance and/or medical claims analytics + Proficiency in data analysis and one...Strong communication skills + Strong working knowledge of healthcare claims as it relates to trend analytics, total cost… more
- New York State Civil Service (Latham, NY)
- …and files.* Receive, screen, review, and verify documents, forms, applications, claims , and other documents for completeness, content, and accuracy. * Establish ... processing credit card transactions.* Constant communication with various individuals to field questions, elicit and convey information, and resolve issues. *… more
- ManpowerGroup (Chester, NY)
- …and coordinate wellness initiatives. + Research and resolve benefit issues including claims assistance and assist with Open Enrollment and ACA compliance. **What's ... of benefits experience preferred. + Knowledge of benefits and claims processes, as well as HR benefit laws such...+ Opportunity to gain valuable experience in the HR field . + Work in a supportive and collaborative environment.… more