- Cognizant (Albany, NY)
- …or requested; and other duties as assigned. Maintain and particpate in all Mass Health forums to understand, translate and implement Mass Health guidelines to ... team environment + Extensive knowledge of Massachusettes Medicaid Mass Health laws required + Experience with Mass Health... Health laws required + Experience with Mass Health governing policies and proedures and procedural knowledge of… more
- Centers Plan for Healthy Living (Staten Island, NY)
- …provide members and all those involved in their care with the guidance and health plan choices they need for healthy living. CPHL is committed to providing quality, ... coordinated health care to some of the most honored and yet still vulnerable members of our community. Centers Plan for Healthy Living (CPHL) appreciates its team… more
- Evolent (Albany, NY)
- …**What You Will Be Doing:** + Answer and manage inbound inquiries regarding health plan benefits and claims , eligibility, medical and other healthcare ... **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
- 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
- IBM (New York, NY)
- …Veeva PromoMats for Healthcare & Life Science customers (pharma, medical device, consumer health , etc). - Expertise with Claims , DAM (Digital Asset Management), ... Modular Content, MLR review. - Experience with regulated content management systems such as Veeva Vault, Documentum, Vodori, etc. - Experience working with a DAM tool such as Aprimo, Adobe, Bynder, etc. - Experience working with a CRM tool such as Veeva CRM,… more
- Mount Sinai Health System (New York, NY)
- …law, and the revenue cycle, with particular focus on PB and HB claims . o Understanding of the legal and regulatory environment surrounding healthcare contract ... across both professional billing (PB) and hospital billing (HB) claims . * Ensure that all contract terms are properly...Us** **Strength through Unity and Inclusion** The Mount Sinai Health System is committed to fostering an environment where… more
- Mount Sinai Health System (New York, NY)
- **Job Description** Responsible for ensuring that unpaid and partially paid claims are resolved in an efficient and timely manner. Resolves EOB discrepancies and ... required. Familiarity with CPT and ICD (coding and CCI edits). + Electronic claims processing preferred. **Responsibilities** 1. Follows up on submitted claims ,… more
- Whitney Young Health Center (Albany, NY)
- …the billing and collection of medical services. This includes: creating claims according to regulations and compliance guidelines, patient account research and ... identification of payment variance invoices, follow up and resolution of denied claims . Responsible for working correspondence denials and insurance follow up. This… more
- CVS Health (Amherst, NY)
- At CVS Health , we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming ... health care. As the nation's leading health ...and systematic setup essential to the processing of our claims adjudication system. Meritain's proprietary system provides a benefit… more
- CenterLight Health System (NY)
- …will play a pivotal role in enhancing the efficiency and effectiveness of the claims department by timely and accurate processing of claims appeals and ... guidelines. This position emphasizes the appeals review and auditing of claims to drive process improvements and achieve measurable outcomes. JOB RESPONSIBILITIES:… more