- Evolent (Albany, NY)
- …a Coordinator role either requesting or submitting prior authorization requests and/or relevant health care experience in claims or appeal & grievances is ... **Your Future Evolves Here** Evolent partners with health plans and providers to achieve better outcomes...better outcomes for people with most complex and costly health conditions. Working across specialties and primary care, we… more
- Molina Healthcare (Syracuse, NY)
- …Bachelor's Degree or equivalent experience Prior experience in Payment Integrity and/or COB/ Claims roles at a health plan or vendor. Familiarity with ... Lead Analyst, Configuration Oversight to support our Payment Integrity and Claims Operations teams in ensuring the accuracy and compliance of Coordination… more
- Centene Corporation (New York, NY)
- …implementation of recommendations to providers that would improve utilization and health care quality. + Reviews claims involving complex, controversial, ... 28 million members as a clinical professional on our Medical Management/ Health Services team. Centene is a diversified, national organization offering competitive… more
- Mount Sinai Health System (New York, NY)
- **Job Description** Mount Sinai is one of the largest US health systems with a strong reputation for quality of care and research. We have over 38,000 employees ... a transition to a business model focused on population health management - our goal is to keep entire...potential legal intervention, and assisting in the escalation of claims that may require involvement from insurance carriers or… more
- Robert Half Accountemps (Syracuse, NY)
- …position, you will play a vital role in managing billing processes for Home Health Care services, ensuring accuracy in claims submission and payment processing. ... correcting any missing or incorrect details related to Home Health Care billing. * Prepare and submit claims and invoices to payors or clients in accordance with… more
- Catholic Health (Buffalo, NY)
- …Days Hours: 8-4 Summary: The Healthcare Analyst II will be responsible for analyzing health care electronic medical record and claims data in order to track ... care utilization and quality of care for the population health business model. This responsibility requires that the analyst...internal customers. The reports will be used to monitor health care quality and utilization within the CMP network… more
- Catholic Health (Buffalo, NY)
- …Healthcare Analyst III will be responsible for compiling, formatting, maintaining and analyzing health care electronic medical record and claims data in order to ... care utilization and quality of care for the population health business model. This responsibility requires that the analyst...internal customers. The reports will be used to monitor health care quality and utilization within the CMP network… more
- WMCHealth (Valhalla, NY)
- …Features of the Class: Under general supervision, an Insurance Clerk processes insurance claims to third party health carriers for billing of medical services ... Responsibilities include initial billing, investigation and reconciliation of problem claims , maintaining automated accounts, filing, and other clerical tasks.… more
- Mount Sinai Health System (New York, NY)
- …and analytic development skills and impact the patient community of the Mount Sinai Health System. Serves as mentor to others in the Data Science team and takes ... minimum, higher preferred, in analytics development expertise, preferably in health care, or for a health provider,...care EMR such as Epic/Clarity, aCW, etc.; a payor claims system such as Facets, Amisys, etc.; or a… more
- Mount Sinai Health System (New York, NY)
- **Job Description** Mount Sinai is one of the largest US health systems with a strong reputation for quality of care and research. We have over 38,000 employees ... of patients. We are accelerating a transition to a business model focused on population health management - our goal is to keep entire communities healthy and out of… more