- Molina Healthcare (NY)
- …**Job Summary** Respond to inbound calls to provides support for provider claims adjudication activities including responding to providers to address claim issues, ... and researching, investigating and ensuring appropriate resolution of claims . **Knowledge/Skills/Abilities** + Responds to incoming calls from providers regarding … more
- Molina Healthcare (Yonkers, NY)
- JOB DESCRIPTION Job Summary Provides support for claims recovery activities including researching claim payment and billing guidelines, audit results, and federal ... to facilitate recovery of outstanding overpayments. Monitors and controls backlog and workflow of claims and ensures that claims are settled in a timely fashion… more
- Molina Healthcare (Buffalo, NY)
- …Job Summary Respond to inbound calls to provides support for provider claims adjudication activities including responding to providers to address claim issues, and ... researching, investigating and ensuring appropriate resolution of claims . **Essential Job Duties** * Responds to incoming calls from providers regarding claims … more
- Molina Healthcare (Syracuse, NY)
- …or team leadership experience + 10 years' work experience preferable in claims processing environment and/or healthcare environment + Strong knowledge of ... strategic analysis. **KNOWLEDGE/SKILLS/ABILITIES** Manages and provides direct oversight of Healthcare Analytics Team activities and personnel. Provides technical expertise,… more
- Humana (Albany, NY)
- …JD, MSN, Clinical Certifications, CPC, CCS, CFE, AHFI). + Understanding of healthcare industry, claims processing and investigative process development. + ... experience to include multiple practice areas + At least 2 years of healthcare fraud investigations and auditing experience + Knowledge of healthcare payment… more
- Norstella (Albany, NY)
- …(PharmD) or Medicine (MD/DO) degree. + Experience working with and querying large healthcare databases, including claims , EMR/EHR, and laboratory data, in an ... **The Role:** In this role, you will leverage your expertise in ** healthcare data analytics** to extract meaningful insights from **real-world data (RWD)** sources,… more
- MVP Health Care (Schenectady, NY)
- … healthcare quality data highly preferred + Subject matter expertise in healthcare data- claims , coding, HIE's etc. Experience with quality metrics, (NCQA ... opportunity for you if you have a passion for healthcare , innovation, and collaboration. **What's in it for you:**...that may arise, reflecting our collective goal of enhancing healthcare delivery and being the difference for the customer.… more
- Robert Half Accountemps (Forest Hills, NY)
- …* Prepare and process billing statements and invoices with precision. * Handle claims processing for Medicaid and healthcare -related billing. * Investigate and ... in billing or a related role. * Proficiency in healthcare billing, including Medicaid claims . * Strong understanding of billing functions and processes. *… more
- CDPHP (Latham, NY)
- …these values and invites you to be a part of that experience. The Claims Representative shall assume full responsibility and ownership for all aspects regarding ... claims adjudication and adjustments. In addition, the incumbent will...determinations and verifications based on State statutes relating to healthcare administration and corporate guidelines. + Demonstrated ability to… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …role will require coming into the Rochester, NY office. The LTC Claims Administration Specialist performs timely and accurate data-entry and transactional processing ... in the claims administration system. The incumbent processes and adjudicates Long-Term...demonstrates high standards of integrity by supporting the Lifetime Healthcare Companies' mission and values, adhering to the Corporate… more