- Walgreens (East Elmhurst, NY)
- …enhancements to pharmacy systems to further promote productivity. + Ensures the accurate processing of insurance claims to resolve customer issues and prevent ... privacy, generics, less expensive medicines, over-the-counter products, and refers to medical provider as needed to ensure medication is taken correctly, health… more
- Walgreens (Peekskill, NY)
- …enhancements to pharmacy systems to further promote productivity. + Ensures the accurate processing of insurance claims to resolve customer issues and prevent ... privacy, generics, less expensive medicines, over-the-counter products, and refers to medical provider as needed to ensure medication is taken correctly, health… more
- Public Consulting Group (Albany, NY)
- …+ Third Party Administrator Services + Enhance Health and Public Safety Services + Claims Processing Services and Solutions + Consulting and Advisory Services + ... options + Develops effective working relations and cooperate with medical team throughout the entire case management process +...working experience in case management, including as a nurse, medical , mental health care manager or a related job… more
- Mount Sinai Health System (New York, NY)
- …ideal candidate will have had some experience working with health administrative/insurance claims data and other large datasets. Prior experience with the Department ... either lead or co-author manuscript publications. Responsibilities will include processing large datasets, performing statistical analyses, developing models, preparing… more
- OLV Human Services (Lackawanna, NY)
- …individuals. - Leads the Site Team in weekly discussion to ensure that all medical appointments are completed as scheduled and that all necessary follow up is ... (Including but not limited to: Life Plans, LCED's, meal intake, medical monitoring, medication administration, staff action program data/goals, Therap notes,… more
- City of New York (New York, NY)
- …responsible for managing payments for over 500 active contracts. - Direct the processing of approximately 30,000 Medicaid reimbursement claims per month, related ... /Division of Accounts Receivable (DAP) comprise of Miscellaneous Contracts & Medical Payments, Employment Program Payments, the operations of Contract Agency Monthly… more
- Highmark Health (Albany, NY)
- …(AHFI) **SKILLS** + Must have knowledge of provider facility payment methodology, claims processing systems and coding and billing proficiency + Must ... to prevent further improper payments.Forwards case to the Credentialing and/or Medical Review Committee, law enforcement and regulatory agencies. + Responsible for… more
- CVS Health (New York, NY)
- …NextGen Production Support Environment team, focusing on Non-Production Support: + Claims system: Health Rules Payer (HRP) + Enrollment systems: Market Prominence ... multi-tier applications. + 3+ years experience with or exposure to batch processing , monitoring technologies, and trend analysis + Knowledge or experience with… more
- CVS Health (New York, NY)
- …mathematical analysis methods, including predictive analytics, natural language processing , reinforcement learning and causal inference with in-depth specialization ... in some areas + Experience working with healthcare data, including claims data, provider data, and / or clinical data + Experience mentoring junior data scientists… more
- CDPHP (Albany, NY)
- …two (2) years Utilization Management experience is preferred. + Knowledge of coding/ claims processing is preferred. + Experience working with Microsoft Office, ... authorization. This includes approval determinations and appropriate exceptions, coordinating with Medical Directors on denials. In addition, the UR nurse is… more