- Humana (Albany, NY)
- …to assignments. The Senior Encounter Data Management professional ensures data integrity for claims errors that result from the data exchange between Humana and its ... to make an impact** **Required Qualifications** **5+ years of medical claims processing/auditing or encounter data management experience** **Demonstrated deep dive… more
- UHS (Binghamton, NY)
- …this role, you will investigate, analyze, and resolve denied insurance claims -ensuring timely reimbursement and supporting the financial integrity of our ... collaborate with payers, providers, and internal teams to turn denials into resolved claims and confusion into clarity. Join a team where your work strengthens not… more
- Highmark Health (Albany, NY)
- …MUST BE A US CITIZEN This position serves as a key liaison between Claims Operations , Customer Service, Regulatory Affairs, IT, Legal and other departments, ... industry regulatory changes and assess their potential impact on Claims Operations , Customer Service and other operational...Health Insurance Industry + 3 - 5 years the Healthcare Industry + 3 - 5 years in Lean/Six… more
- Walgreens (Wading River, NY)
- …that reflect the unique communities we serve as requested by Store Manager, Healthcare Supervisor, or District Manager. Operations + Counsels patients and ... medications and drug interaction awareness. Offers preventive and clinical healthcare services, including immunizations, diagnostic testing, and patient outcome… more
- Evolent (Albany, NY)
- …growth opportunities at customer accounts + Strong knowledge of health plan operations , care/utilization management, claims processing, value-based care, and the ... Provider Solutions, Strategic Accounts, Analytics, Client Finance, Implementation, Clinical Operations , Medical, Quality, and Call Center Teams) to identify new… more
- Otsuka America Pharmaceutical Inc. (Albany, NY)
- Otsuka Pharmaceutical Company is a global healthcare company with the corporate philosophy: "Otsuka-people creating new products for better health worldwide." Otsuka ... etc.** + Excellent working knowledge of phase I clinical operations , drug development, multi-region regulatory requirements. + Good working...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more
- BronxCare Health System (Bronx, NY)
- Overview Conduct review of denied claims and audits of registration/insurance verification activities to improve denial rates and enhance revenue. In-service staff ... collection, analysis, implementation of and compliance with risk management and claims activities, support of and participation in Continuous Quality Improvement… more
- Humana (Albany, NY)
- …They will work closely with IT, the pricing software vendor, CIS BSS, Medicaid operations , claims operations , and other business teams involved in the ... APR-DRG and/or EAPG grouper logic + Experience processing or reviewing facility claims + Prior professional experience utilizing Microsoft Excel (eg performing basic… more
- Walgreens (Peekskill, NY)
- …+ Participates and assists in community events as requested by Store Manager, Healthcare Supervisor, District Manager or Pharmacy Manager. ** Operations ** + Under ... usage of medications, awareness with drug interactions and offering preventive healthcare services such as immunizations. Responsible for ensuring the proper… more
- Walgreens (Norwich, NY)
- …until satisfied, etc.). Develops strong relationships with most valuable customers. Operations Under the supervision by the pharmacist, assist in the practice ... the pharmacist, including those to physicians. Processes (corrects and resubmits) manual claims for third party program prescription services in a timely and… more