- KPH Healthcare Services, Inc. (Oneonta, NY)
- …setting.** **Job Summary:** Responsible for the implementation and adherence to Noble Health Services policies and procedures as it relates to the provision of ... the highest quality health care service to our patients. Facilitate Clinical Management...and procedures at all times + Monitors all pharmacy claims for proper reimbursement + Assist in managing the… more
- The Cigna Group (New York, NY)
- …of communication with matrix partners including but not limited to, Claims Operations, Medical Management. Credentialing, Legal, Medical Economics, Compliance, Sales ... of benefits, with a focus on supporting your whole health . Starting on day one of your employment, you'll...day one of your employment, you'll be offered several health -related benefits including medical, vision, dental, and well-being and… more
- Access: Supports For Living (Middletown, NY)
- …$100 million in annual billing. We seek an Accountant specializing in Behavioral Health insurance billing and Medicaid Managed Care billing. The ideal candidate will ... have expertise in Net Smart for Behavioral Health and play a key role in financial operations,...receivable, including cash/denial postings and follow-up on MCO insurance claims . + Independently create and maintain spreadsheets and databases… more
- WTW (New York, NY)
- …phone and face to face with clients. + Champion the proper advocacy of claims . + Participate in stewardship meetings. + Support Client Management team in identifying ... package which includes the following (eligibility requirements apply): + ** Health and Welfare Benefits:** Medical (including prescription coverage), Dental, Vision,… more
- University of Rochester (Rochester, NY)
- …coding guidelines. - Reviews and resolves coding denials. Resolves problems with claims having errors related to improper coding and provides feedback for correction ... or incomplete. QUALIFICATIONS: - HS Diploma - Associates degree in Health Information Technology or health related field - 2 years' experience as Medical Coder… more
- CDPHP (Latham, NY)
- …in 1984, CDPHP is a physician-founded, member-focused, and community-based not-for-profit health plan that offers high-quality affordable health insurance to ... + Willingness to develop relationships with partners within the health plan to both understand data requests and help...care system and experience working with physician or hospital claims /group data preferred. In depth knowledge of product and… more
- Walgreens (Brooklyn, NY)
- …of a pharmacist assists with healthcare service offerings including administering vaccines, health screenings, and any health services allowed by law. + ... Quality Improvement Program. + Ensures the accurate processing of insurance claims to resolve customer issues and prevent payment rejections. Follows-up with… more
- St. John's Embrace Living (Rochester, NY)
- …expertise in managing a patient billing and accounting department within a complex health care facility + Data processing and billing systems as they relate to ... health service financial and billing + Principles of patient...associated with paying privately. + Prepares and submits billing claims for Private, Medicare, Medicaid and other third-party insurances… more
- Molina Healthcare (Rochester, NY)
- **JOB DESCRIPTION** **Job Summary** Molina Health Plan Provider Network Management and Operations jobs are responsible for network development, network adequacy and ... serves as the primary point of contact between Molina Health plan and the Provider community that serves Molina...2 - 3 years customer service, provider service, or claims experience in a managed care setting. + Working… more
- Centene Corporation (Queens, NY)
- …one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national ... obligations with State and Federal agencies such as New York State Department of Health (NYDOH), County Department of Health (CDOH), Local Department of Social… more