- Elevance Health (East Syracuse, NY)
- …via telephone and written correspondence regarding benefits, contracts, eligibility and claims . + Analyzes issues and provides information and/or solutions. + ... Prior call center or customer service experience within the healthcare industry is highly preferred. + Strong knowledge of... industry is highly preferred. + Strong knowledge of claims is preferred. + Strong verbal and written communication… more
- Centene Corporation (Queens, NY)
- …(HMO, PPO, Medicaid, Medicare Advantage, Duals, SNPs). + Familiarity with healthcare laws, reimbursement models, and value-based care initiatives. + Perform duties ... related to operational areas. + Oversee day-to-day operations including claims processing, provider network management, member services, utilization management, and… more
- Elevance Health (Latham, NY)
- …+ Trains associates on all upskilling of customer service and claims to include providing professional medical service facility correspondence, usage of ... healthcare provider portals, and adjustments. + Serves as an...equivalent background. **Preferred Skills, Capabilities and Experiences:** + FEP Claims or Customer Service experience highly preferred. + Strong… more
- Walgreens (Loudonville, NY)
- …the pharmacist, including those to physicians. Processes (corrects and resubmits) manual claims for third party program prescription services in a timely and ... Maintains knowledge of Company asset protection techniques, and files claims for warehouse overages (merchandise received, but not billed), shortages… more
- Humana (Albany, NY)
- …timely and accurate submission of mandated reports, leveraging their understanding of claims data and Medicaid program requirements to drive accurate and timely ... pivot tables and summarizing data into reports and dashboards + Experience working with claims data + Experience working with big and complex data sets within large… more
- CVS Health (Albany, NY)
- …by ensuring compliance with regulatory and accreditation standards while driving healthcare quality initiatives. This role combines clinical expertise with quality ... requirements. + Apply clinical criteria and policies to member/provider claims and coordinate clinical resolutions with MD support. **Performance Improvement… more
- CenterWell (Albany, NY)
- …Medical Director, Primary Care relies on medical background and reviews health claims . The Medical Director, Primary Care work assignments involve moderately complex ... factors. The Medical Director relies on medical background and reviews health claims . The Medical Director work assignments involve moderately complex to complex… more
- SUNY Upstate Medical University (Syracuse, NY)
- …from clinical departments, physicians, and Financial Service staff to ensure claims are billed and/or resubmitted with appropriate coding. Responsible to assist ... ambulatory departments with coding issues and/or questions to ensure claims are billed compliantly and accurately based on medical record documentation. Minimum… more
- The Salvation Army (Elmira, NY)
- …Corps SCOPE AND PURPOSE OF POSITION: This job is for a licensed healthcare practitioner who is eligible and qualified to order/refer Medicaid reimbursable services ... OASAS 820 re-integration program. The Practitioner's NPI will be reported on claims submitted to Medicaid. The only qualified practitioners for this position include… more
- City of New York (New York, NY)
- …most impacted NYC communities. CHECW addresses inequity across community and healthcare systems in partnership with community, faith-based, and health care ... the Agency's Chief Medical Officer. The Bureau of Equitable Health Systems is the healthcare systems bureau of DOHMH. Our mission is to apply policy, evidence, and… more