- Evolent (Albany, NY)
- **Your Future Evolves Here** Evolent partners with health plans and providers to achieve better outcomes for people with most complex and costly health ... care, we seek to connect the pieces of fragmented health care system and ensure people get the same...Evolent will serve as a point of contact for processing post determination reviews and appeals requests in accordance… more
- Humana (Albany, NY)
- …of experience researching MS-DRG, APR-DRG and/or EAPG grouper logic + Experience processing or reviewing facility claims + Prior professional experience ... part of our caring community and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst...IT, the pricing software vendor, CIS BSS, Medicaid operations, claims operations, and other business teams involved in the… more
- Humana (Albany, NY)
- …+ 1 - 3 years of grievance and appeals experience + Previous experience processing medical claims + Bilingual (English and Spanish); with the ability to ... part of our caring community and help us put health first** The Grievances & Appeals Representative 3 manages...+ Prior experience with Medicare + Experience with the Claims Administration System (CAS) + Knowledge of medical terminology… more
- Outreach Development Corporation (Richmond Hill, NY)
- …helps people address the issues stemming from substance use and behavioral health disorders by providing the highest quality, life-changing treatment, training and ... potential by developing and delivering the highest quality evidence-based behavioral health services and training. For more information, please visit www.opiny.org.… more
- New York State Civil Service (Endicott, NY)
- …responsible for the following;. Accept and process both original and continued claims for Unemployment Insurance. . Conduct telephone interviews with claimants in ... benefits.. Determine the need for further fact-finding and place claims on hold pending further investigation. Work a variety...bartender, wait staff, hair stylist, bus driver, or home health aide, etc. Note: It is essential that you… more
- City of New York (New York, NY)
- …and/or systems. - Design, test, and implement the process to evaluate claims for skimming reimbursement in a batch, data-driven manner, with 100% accuracy ... thousands of staff work hours, and single-handedly ensuring that over 80,000 claims are correctly processed. - Coordinate planning, set policies and prioritize the… more
- City of New York (New York, NY)
- …the City fisc, and to represent the City in the array of claims that arise in its operations. Topics include inter-governmental disputes, municipal corruption, ... public health , insurance coverage, commercial disputes, tenant protection matters and...supplemented by 12 semester credits in secretarial science, word processing , office automation and/or office technology; or 2. An… more
- UIC Government Services and the Bowhead Family of Companies (New York, NY)
- …is full-time, benefits eligible at an hourly rate of $22.72 plus $4.93 H&W ( Health and Welfare) rate per local wage determination. The location is in New York, ... required. + Extensive computer/PC knowledge required including; spreadsheet software, word processing software and knowledge of MS Office Suite. + Must be… more
- Molina Healthcare (Albany, NY)
- …models to support analytical and operational use cases, including healthcare claims and utilization data. * Collaborate with cross-functional teams, including data ... Presto, Phoenix, Kylin, and Hadoop (HDFS, YARN). * Experience building real-time stream- processing systems using Kafka, Storm, or Spark Streaming. * Strong knowledge… more
- Family of Kidz (Harrison, NY)
- …+ Medical, Dental, and Vision Insurance + 401(k) + Flexible Spending and Health Savings Accounts + Life Insurance + Employee Assistance Program + Referral Program ... all child demographic into the system + Assist in processing and scheduling services for EI and CPSE children...to correct files as needed + Cleanup projects in CLAIMS + Ensure receipt and distribution of all necessary… more