- Molina Healthcare (Buffalo, NY)
- …executive decision-making + Mine and manage information from large data sources. + Analyze claims and other data sources to identify early signs of trends or other ... of provider reimbursement changes + Provide data driven analytics to Finance, Claims , Medical Management, Network, and other departments to enable critical decision… more
- Mohawk Valley Health System (New Hartford, NY)
- …resolution of incidents, claims and litigation matters. + Is available to field inquiries from our staff outside of normal business hours. + Performs related ... of safety, throughout the organization. Responsible for management of pending insurance claims and partnering with brokers and insurers. Core Job Responsibilities +… more
- Colgate-Palmolive (New York, NY)
- …return-to-work dates with HRBPs. Coordination of Workers' Compensation: + Coordinate Claims and Benefits: Integrate Workers' Compensation claims with concurrent ... benefit payments across sources to prevent overpayments and ensure accurate claims processing. Required Qualifications: + Bachelor's degree in Human Resources,… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …required by the Company. + Evaluates Insured's condition through review of field assessments, medical records, etc. Determines benefit eligibility based on the ... of services as is deemed necessary. + Evaluates submitted claims to determine if services billed and provided are...License or bachelor's degree in social work or related field . In lieu of an RN or bachelor's degree,… more
- MTA (New York, NY)
- …for the overall management of a staff of 2 people including the Sr Claims Administrator, 1 Analyst and approximately 7 consultants. + Responsible for the management ... and assess loss picks, ensuring accuracy in estimating future claims costs. Oversees OCIP claims and settlements...degree in Finance, Risk Management, Business, or a related field or an equivalent combination of education and experience… more
- Molina Healthcare (Buffalo, NY)
- …for accurate and timely maintenance of critical provider information on all claims and provider databases. Synchronizes data among multiple claims systems ... & ABILITIES** : 1 year customer service, provider service, contracting or claims experience in the healthcare industry. **PREFERRED EDUCATION** : Associate's Degree… more
- Otsuka America Pharmaceutical Inc. (Albany, NY)
- …Experience:** + Bachelors degree required, advanced degree in life sciences, pharmacy, or related field (Ph.D., PharmD) a plus + Minimum of 7 years of experience in ... you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to...legitimate job opportunity. Scammers may also send offers or claims from a fake email address or from Yahoo,… more
- Otsuka America Pharmaceutical Inc. (Albany, NY)
- …Required + Bachelor's degree in Pharmacy, Chemistry, Biology, Engineering, or related field (Master's or PhD preferred). + 8+ years of experience in pharmaceutical ... you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to...legitimate job opportunity. Scammers may also send offers or claims from a fake email address or from Yahoo,… more
- Kenmore Tonawanda UFSD (Buffalo, NY)
- …college or university, preferably in education, business, accounting, or a related field ; + Certified Public Accountant (CPA) credential. + Minimum of five (5) ... treasury functions, accounting, financial reporting, audit coordination, state aid claims , budget development, capital project oversight, insurance and risk… more
- Humana (Albany, NY)
- …certification from the AAPC and/or AHIMA) + Extensive knowledge of medical claims processing and familiarity with reimbursement methodologies, ICD, CPT, and HCPCS + ... team **Preferred Qualifications** + BS in healthcare or business-related field + Knowledge of internal Medical Coverage Policies and... + Knowledge of internal Medical Coverage Policies and Claims Payment Policies + CAS claims processing… more