- CAI (Albany, NY)
- …6 years of experience or equivalent higher education. Preferred experience in healthcare claims environment and reporting development, n-tier development and ... support, and Microsoft SQL database development including relational and star schema data warehouses + Microsoft data systems certifications such as MTA, MCSA, MCSE, ITIL v3, or equivalent + 2-year degree required. Applicable certifications may substitute… more
- CVS Health (Albany, NY)
- … insurance or a highly regulated industry. + Strong knowledge of healthcare payer operations ( claims , eligibility, enrollment, prior authorization, provider ... data, user feedback, and market research to enhance digital self-service, claims transparency, provider search, member portals, and mobile applications. + Identify… more
- Independent Health (Buffalo, NY)
- …a culture that fosters growth, innovation and collaboration. **Overview** The Claims Adjudicator is responsible for adjudicating and adjusting medical and/or dental ... claims against established criteria, and in accordance with specific...processing/medical billing experience, customer service experience preferably in a healthcare related or social services setting; OR combination of… more
- Cognizant (Albany, NY)
- …a variety of business operations. We are seeking **Fully Remote US Based** Claims Processors to join our growing team. The **Medical** ** Claims Processor** ... responsible for the timely and accurate adjudication of professional and hospital claims utilizing payer specific policies and procedures. Provide support to … more
- MVP Health Care (Rochester, NY)
- …thinking and continuous improvement. To achieve this, we're looking for a Leader, Claims Operations, to join #TeamMVP. If you have a passion for leadership, team ... Minimum 3 years in health insurance or production-related environment. 2 years claims processing experience preferred. + Strong knowledge of Medicaid, Medicare, and… more
- Elevance Health (New Hyde Park, NY)
- ** Claims Representative I** **Location:** This role enables associates to work virtually full-time, with the exception of required in-person training sessions, ... operation are 6 am - 6 pm EST. The ** Claims Representative I** is responsible for successfully completing the...dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with… more
- Norstella (Albany, NY)
- …sciences analytical use cases by querying and analyzing a wide range of healthcare data sources, including claims , lab results, electronic medical records (EMR), ... Norstella's unified Real World Data asset, a combination of claims , lab, SDOH and EMR data. You will be...worked in and understands the dynamics of the US healthcare ecosystem. **Responsibilities:** *As an RWD Analytic Consultant, you… more
- Centers Plan for Healthy Living (Staten Island, NY)
- Centers Plan for Healthy Living's goal is to create the ultimate healthcare experience that provides our members, their families, healthcare decision makers, and ... Responsible for the auditing functions of Centers Plan for Healthy Living (CPHL) claims . Collaborates with other Health plan departments and Management to ensure … more
- Mount Sinai Health System (New York, NY)
- …processes, and related regulations. ? Familiarity with contract terms, NYS regulations, claims processing, and healthcare reimbursement models. ? Experience in ... to Directors for potential legal intervention, and assisting in the escalation of claims that may require involvement from insurance carriers or legal entities. The… more
- Norstella (Albany, NY)
- …relational databases, ensuring data accuracy and quality. *Perform in-depth analyses on healthcare data sources, including claims , lab, EMR/EHR, and SDOH data, ... unified Real World Data asset, NorstellaLinQ, a combination of claims , lab, SDOH and EMR data. You will be...worked in and understands the dynamics of the US healthcare ecosystem. **Responsibilities:** *Lead the delivery of complex RWD… more