- Highmark Health (Albany, NY)
- **Company :** HM Insurance Group **Job Description :** **JOB SUMMARY** This job prices quotes and analyzes the structure of a contract for a group based on claims ... risk factors for new enrollment, annual renewals, and amendments of group insurance contracts or of self-funded plans in conformance with established underwriting… more
- BAE Systems (Endicott, NY)
- …regulations, and laws in its transactions and protect the company against potential claims and litigation. This role is required to be performed in a **hybrid ... + This person will function as a senior level labor and employment specialist supporting the Deputy Chief Counsel, Labor and Employment and the Vice President… more
- OPEN Health (New York, NY)
- …OPEN Health brings together deep scientific knowledge, global understanding, and broad specialist expertise to support our clients in improving health outcomes and ... complex challenges. Being built from cohesive partnerships across a range of specialist sectors gives us the ability to approach opportunities from fresh… more
- Molina Healthcare (Syracuse, NY)
- …of a formal appeal being submitted. + Independently re-evaluates medical claims and associated records by applying advanced clinical knowledge, knowledge of ... with the Chief Medical Officer for Administrative Law Judge pre-hearings, State Insurance Commission, and Meet and Confers. + Represents Molina and presents cases… more
- Kaleida Health (Buffalo, NY)
- …researches coding materials and recommends educational programs. Assists in investigating insurance denials to identify necessary action, corrects claims based ... findings, and identify opportunities and develop a training plan for the coding specialist . Participates in a variety of other departmental quality audits that may… more
- Medtronic (New York, NY)
- …articulate to customers. + Execute engaging field sales and clinical specialist field education programs that are targeted, purposeful, and support electrophysiology ... Clinical Expert + Translates complex technical messaging, dispels competitive claims , resolves complex technical issues, and maintains customer relationships through… more
- Adecco US, Inc. (New York, NY)
- …investigation and prior authorization * Provide patient access support related to claims , denials, and appeals * Facilitate training on payer landscape and hub ... considered:** * 8+ years of healthcare reimbursement experience (Medicare & Commercial insurance ) * Strong background in Buy & Bill, Specialty Pharmacy, or related… more
- CenterWell (Liverpool, NY)
- …. Complete End of Period claim workflow as part of Billing Specialist responsibilities. This includes confirming all orders are signed appropriately and coordinating ... team at the branch to ensure other billing requirements are satisfied to release claims timely. . Adhere to and participate in Agency's mandatory HIPAA / Privacy… more
- NBC Universal (New York, NY)
- …and other intellectual property matters; negotiate and settle pre-litigation copyright claims + Respond to pre- and post-publication threats and challenges + ... affecting the press, freedom of speech, and publication + Partner with specialist lawyers across Versant's Legal Department, including on News -related litigation +… more
- Highmark Health (Albany, NY)
- …or Outpatient): Registered Health Information Technician (RHIT), Certified Coding Specialist (CCS) + AAPC Credentials (Outpatient): Certified Professional Coder ... skills Preferred + Associate's Degree + 3 years with claims processing and data management + Past auditing and...this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described… more