- 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
- Ankura (New York, NY)
- …is a team of excellence founded on innovation and growth. Practice Overview: Ankura's Health Care team is a recognized leader in health care disputes, ... their legal counsel rely upon us to successfully resolve complex matters. Ankura's health care team is comprised of clinicians, certified coders, revenue cycle, and… more
- Walgreens (Peekskill, NY)
- …to medical provider as needed to ensure medication is taken correctly, health needs addressed, and satisfaction with service. + Performs pharmacist tasks including ... to further promote productivity. + Ensures the accurate processing of insurance claims to resolve customer issues and prevent payment rejections. Follows- up with… more
- Molina Healthcare (New York, NY)
- …and must live in New York _** **Job Description** **Job Summary** Molina Health Plan Network Provider Relations jobs are responsible for network development, network ... serves as the primary point of contact between Molina Health plan and the Plan's highest priority, high volume...3 - 5 years customer service, provider service, or claims experience in a managed care setting. * 3+… more
- Molina Healthcare (Syracuse, NY)
- …and complies with applicable laws and regulations pertaining to the Health Care environment **Job Duties** The Operational/Regulatory Oversight Sr. Analyst works ... with health plans and operations departments to assess, oversee, and...experience working in Medicare + Must have experience analyzing claims . **Job Qualifications** **REQUIRED EDUCATION:** Associate's Degree and/or equivalent… more
- University of Rochester (Albany, NY)
- …Subtype: Regular Time Type: Full time Scheduled Weekly Hours: 40 Department: 900370 Health Info Mgmt-Coding Work Shift: UR - Day (United States of America) Range: ... guidelines. + Reviews and resolves coding denials. + Resolves problems with claims having errors related to improper coding and provides feedback for correction… more
- Molina Healthcare (NY)
- …and coordinate an integrated delivery of care across the continuum, including behavioral health and long term care, for members with high need potential. HCS staff ... organized and analytical thinking. Experience with Medicare/Medicaid, MS 365 and familiarity with claims is highly preferred. The Case Manager must be able to work… more
- University of Rochester (Rochester, NY)
- …Subtype: Regular Time Type: Part time Scheduled Weekly Hours: 20 Department: 900370 Health Info Mgmt-Coding Work Shift: UR - Day (United States of America) Range: ... reviews to make corrections before transmittal. + Troubleshoots problems that prevent claims from being released. Identifies cause of edit and independently resolves… more
- Molina Healthcare (NY)
- **Job Description** **Job Summary** Molina Health Plan Network Provider Relations jobs are responsible for network development, network adequacy and provider ... serves as the primary point of contact between Molina Health plan and the for non-complex Provider Community that...2 - 3 years customer service, provider service, or claims experience in a managed care setting. * Working… more
- Molina Healthcare (Buffalo, NY)
- …and maintenance of new members and re-enrollment. Processes and maintains health plan's member and enrollment records, employer's monthly reports, sending membership ... rejections. Address a variety of enrollment questions or concerns received via claims , call tracking, or e-mail. Maintain records in the enrollment database.… more