- Humana (Albany, NY)
- …and help us put health first** The Corporate Medical Director relies on medical background and reviews health claims . The Corporate Medical Director ... diverse scope and complexity ranging from moderate to substantial. The Corporate Medical Director provides medical interpretation and decisions about the… more
- Humana (Albany, NY)
- …Disputes team reviews and educates providers when there is a dispute on adjudicated claims that contain a code editing related denial or financial recovery. The ... Medical Coding Coordinator performs advanced administrative, operational, and customer...apply intermediate mathematical skills. **Where you Come In** The Medical Coding Coordinator extracts clinical information from a variety… more
- Sedgwick (Albany, NY)
- …as it relates to policy language and advises client of the outcome. + Handles medical claims (under P&I coverage) from beginning to end requesting medical ... Insurance Marine Investigator **PRIMARY PURPOSE** **:** To perform detailed admiralty claims investigation and analysis through examination of the loss, collection… more
- Amazon (New York, NY)
- …of actuarial reserving, forecasting and medical economics -Expertise in working with medical claims data and using programming languages such as SQL, R, SAS, ... Description Amazon One Medical is hiring a Actuarial Manager Analyst. Actuarial...implement an actuarially sound monthly reserving process for Total Medical Expense (TME) estimation, and lead continuous evaluation of… more
- University of Rochester (Rochester, NY)
- …advanced coder in the abstraction and in-depth analysis of a variety of medical documentation and assigns appropriate procedural terminology and medical codes in ... and manipulates database. Responds to or clarifies internal requests for medical information. **ESSENTIAL FUNCTIONS** + Uses thorough knowledge of coding systems… more
- CVS Health (Albany, NY)
- …**Position Summary** The Negotiator Analyst is responsible for negotiating out-of-network (OON) medical claims valued at $10,000 and above. This role involves ... metrics **Required Qualifications** + 3-5 years of experience in a medical claim background with demonstrated ability and strong understanding of benchmarking… more
- University of Rochester (Rochester, NY)
- …Understands Coding workflows for abstract coding, resolving coding charge review and claim edits, and resolving coding denials. 25% Identifies and escalates coding ... issues and trends to management. Assists in recommending coding workflow solutions to resolve issues and improve operations. Facilitates staff training on new processes or identified quality issues. 25% The Coding Lead will retain coding assignments in their… more
- WMCHealth (Valhalla, NY)
- …of clerical experience, one year of which included the processing of patients' medical insurance claims as the primary function of the position. Substitutions: ... is no substitution for the one year of specialized experience processing patients' medical insurance claims . *Special Note: Education beyond the secondary level… more
- Baylor Scott & White Health (Albany, NY)
- …(Commercial, DTE, Medicare, and Medicaid). Candidate will oversee extracting and analyzing medical and pharmacy claims data, translating output into business ... **JOB SUMMARY** 100% remote position** The Medical Trend Analytics Manager 1 is responsible for...with excellent healthcare business acumen and communication skills. The Medical Trend Analytics Manager 1 manages a team that… more
- Trinity Health (Troy, NY)
- **Employment Type:** Full time **Shift:** Day Shift **Description:** **Sr Registration Associate ( Medical Receptionistt) - Troy, NY** If you are looking for an ... related to the efficient and service-oriented operation of a medical practice. The Senior Registration Associate will perform all...Scheduling and registration + Check-in + Check-out + Charge entry/ claims + End of day processes + General duties… more