- CenterWell (Albany, NY)
- …+ Know and continually review medication brand and generic names, medical terminology, and pharmaceutical calculations. + Medication adherence outreach, auditing, ... + Assist clinical pharmacists in troubleshooting prescription third party claim rejections by accessing and understanding formulary restrictions, plan limitations,… more
- CVS Health (Amherst, NY)
- …and timely policy and eligibility data utilizing administration systems for claim payment purposes and product production ensuring services and products meet ... issues + Partner directly with clients, vendors, internal teams, and/or local claim operation to resolve problems and achieve positive outcomes + Anticipate and… more
- Otsuka America Pharmaceutical Inc. (Albany, NY)
- …customer engagement platforms, starting with, but not limited to, Otsuka's Medical Affairs Disease State Engagement platforms (PsychU, PsychUsim, ADPKDsim, and ... align our platform initiatives to corporate, above brand and medical strategies. This successful candidate will need strong project...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more
- Sharecare (Albany, NY)
- …eligibility, benefit education, open enrollment / new hire plan selection, claims issues, ID card issues, grievances/appeals, utilization management (UM) status, ... including but not limited to medical , dental, and vision plans + Provider search (PCP,...resolution with providers, payers or 3rd parties for: + Claims adjustments + Grievances and appeals submissions + Utilization… more
- Mount Sinai Health System (New York, NY)
- …the US with a strong reputation for quality of care (18th ranked academic medical center) and research/education (22nd ranked medical school). Our health system ... roles ? Advanced analytical capabilities required, experience with healthcare claims analysis and clinical quality measures highly preferred ?...Sinai Health System is one of the largest academic medical systems in the New York metro area, with… more
- Sumitomo Pharma (Albany, NY)
- …company's new and established programs. This position reports to the Chief Medical Officer. **Job Duties and Responsibilities** + Strategic thought partner including ... and operational leadership to the Marketing Brand Teams, Legal, Medical Affairs and Clinical Research in the development of...the adequacy of clinical evidence provided to support proposed claims and assess consistency of proposed claims … more
- WMCHealth (Poughkeepsie, NY)
- …Applicant link Job Details: Job Summary: The Patient Accounting Clerk processes insurance claims to third party health carriers for billing of medical services ... Responsibilities include initial billing, investigation and reconciliation of problem claims , insurance follow up, filing, and other clerical tasks.… more
- Intermountain Health (Albany, NY)
- …an overall goal of account resolution. + Abel to navigate various payer claim portals and understand payer functionality. + Interacting with others by effectively ... English. **Skills** + Recognizing true overpayments from false credits + Researching claim cycle + Understanding Coordination of Benefits + Understanding EOB +… more
- Allied Universal (Poughkeepsie, NY)
- …will reflect in our communities and customers we serve. We offer medical , dental, and vision coverage, life insurance, retirement plans, employee assistance ... As a Part-Time Security Officer, you'll use our exclusive Claim a Shift platform to view and Pick up...You'll Do:** + Use our proprietary scheduling platform to claim open shifts at client sites + Support operations… more
- Allied Universal (White Plains, NY)
- …will reflect in our communities and customers we serve. We offer medical , dental, and vision coverage, life insurance, retirement plans, employee assistance ... As a Part-Time Security Officer, you'll use our exclusive Claim a Shift platform to view and Pick up...You'll Do:** + Use our proprietary scheduling platform to claim open shifts at client sites + Support operations… more