- CVS Health (Amherst, NY)
- …This challenging role provides exposure to virtually all aspects of healthcare claims administration, from reinsurance/stop loss, data analytics, provider ... loss carrier. **Required Qualifications** *Minimum of 1 year of experience in healthcare claims processing *Minimum of 2 years of experience with the suite of… more
- Humana (Albany, NY)
- …from either the state agency or payer perspective + Detailed understanding of healthcare claims Travel: While this is a remote position, occasional travel ... benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also...our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions… more
- Highmark Health (Albany, NY)
- …You will proactively identify opportunities to construct and leverage comprehensive healthcare knowledge graphs, integrating diverse patient, provider, claims , ... from concept to prototype. + ** Healthcare Data Familiarity:** Understanding of healthcare data domains ( claims , clinical, EMR) and related ontologies or… more
- Molina Healthcare (Yonkers, NY)
- …Description** **Job Summary** Responsible for work load assignment to the provider Claims adjudicators and senior provider claims adjudicators. Train and coach ... new employees. Provide clear and concise results on the provider claims model across all states. Monitors and controls workflow. Provides support to leadership… more
- Molina Healthcare (Yonkers, NY)
- **JOB DESCRIPTION** **Job Summary** Responsible for administering claims payments, maintaining claim records. Monitors and controls backlog and workflow of claims ... **KNOWLEDGE/SKILLS/ABILITIES** + Meets and consistently maintains production standards for Claims Adjudication. + Supports all department initiatives in improving… more
- Molina Healthcare (Rochester, NY)
- **Job Description** **Job Summary** The Provider Claims Adjudicator is responsible for responding to providers regarding issues with claims , coordinating, ... investigates and confirms the appropriate resolution of claims issues. This role will require actively researching issues to adjudicate claims Requires knowledge… more
- Molina Healthcare (Yonkers, NY)
- **JOB DESCRIPTION** **Job Summary** Responsible for administering claims payments, maintaining claim records. Monitors and controls backlog and workflow of claims ... cost control standards. **KNOWLEDGE/SKILLS/ABILITIES** + Evaluates the adjudication of claims using standard principles and state specific policies and regulations… more
- Molina Healthcare (Syracuse, NY)
- **JOB DESCRIPTION** **Job Summary** Responsible for administering claims payments, maintaining claim records, and providing counsel to claimants regarding coverage ... amount and benefit interpretation. Monitors and controls backlog and workflow of claims . Ensures that claims are settled in a timely fashion and in accordance… more
- Molina Healthcare (Buffalo, NY)
- …accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims databases. Synchronizes ... for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare … more
- Norstella (Albany, NY)
- …(MD/DO), or a related field. + Experience working with and querying large healthcare databases, including claims , EMR/EHR, and laboratory data, in an academic ... are seeking a Senior Medical Analyst to join our team and drive data-driven healthcare initiatives. In this role, you will leverage your expertise in healthcare … more