• Customer Care Representative I

    Elevance Health (New Hyde Park, NY)
    …via telephone regarding insurance benefits, provider contracts, eligibility and claims . + Analyzes problems and provides information/solutions. + Operates a ... limited knowledge of company services, products, insurance benefits, provider contracts and claims . Seeks, understands and responds to the needs and expectations of… more
    Elevance Health (08/19/25)
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  • Billing & Accounts Receivable Supervisor

    OLV Human Services (Lackawanna, NY)
    …+ Ensure the timely and accurate preparation and submission of billing claims and anticipated payments. + Regular communication with payers (insurance companies, ... of monthly revenue, utilization, and accounts receivable reports. + Processing of billing claims as necessary. + Updating of rate and procedure codes as necessary. +… more
    OLV Human Services (08/19/25)
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  • Encounter Data Management Professional

    Humana (Albany, NY)
    …problems within the encounter process between Humana and CMS using data analysis, claims research, and other resources to provide insight and ensure data integrity ... for Medicare/Medicaid claims errors. **Key Role Functions** + Develop business processes...extends outside of work. Among our benefits, Humana provides medical , dental and vision benefits, 401(k) retirement savings plan,… more
    Humana (08/19/25)
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  • Senior Patient Account Representative

    Northwell Health (New Hyde Park, NY)
    …Medicaid billing regulations, guidelines, and compliance requirements (eg, medical necessity, Local Coverage Determinations (LCDs), National Coverage Determinations ... Correct Coding Initiative (NCCI) edits and their impact on claims + Ability to analyze large datasets (eg, ...claims + Ability to analyze large datasets (eg, claims data, denial trends) to identify patterns, root causes… more
    Northwell Health (08/16/25)
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  • Workmans Compensation Customer Service…

    Robert Half Finance & Accounting (Albany, NY)
    …Responsibilities: * Oversee existing insurance policies to ensure audits, reports, and claims are managed in compliance with New York State regulations. * Assist ... policyholders by addressing claims , providing educational materials, verifying coverage, and delivering proof of insurance. * Identify and pursue new business… more
    Robert Half Finance & Accounting (08/16/25)
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  • Pricing Actuary

    Axis (New York, NY)
    …Casualty book. They will proactively engage with Reserving, Risk Management, Finance, Claims , and Data & Analytics colleagues to achieve desired business outcomes ... impact of these on the account's profile and emerging claims experience. + Maintain the feedback loop of information...for a comprehensive and competitive benefits package which includes medical plans for you and your family, health and… more
    Axis (08/16/25)
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  • Manager of Workman's Compensation Insurance…

    Robert Half Finance & Accounting (Albany, NY)
    …programs, products, and services. * Process applications and documentation for new claims or policy transfers, ensuring timely submissions. * Manage new and transfer ... * Experience in processing and managing Workers' Compensation applications and claims . * Proficiency in database management and record-keeping systems. * Excellent… more
    Robert Half Finance & Accounting (08/16/25)
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  • Senior Encounter Data Management Professional

    Humana (Albany, NY)
    …The Senior Encounter Data Management Professional ensures data integrity for claims errors. The Senior Encounter Data Management Professional work assignments ... skills to make an impact** **Required Qualifications** + 5+ years of claims operations related experience + Experience with analyzing, reconciling and manipulating… more
    Humana (08/15/25)
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  • Manager, Data Services & Analytics

    New York eHealth Collaborative (New York, NY)
    …large and complex datasets (eg, master patient indexes, SPARCS, healthcare claims ). + Design, implement, maintain, and enhance data workflows, ETL/ELT pipelines, ... data analytics or health informatics within the healthcare industry or a medical environment; strong knowledge of and experience with Health Information Exchange… more
    New York eHealth Collaborative (08/14/25)
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  • Medicaid Provider Hospital Reimbursement…

    Humana (Albany, NY)
    …closely with IT, the pricing software vendor, CIS BSS, Medicaid operations, claims operations, and other business teams involved in the administration of Medicaid ... APR-DRG and/or EAPG grouper logic + Experience processing or reviewing facility claims + Prior professional experience utilizing Microsoft Excel (eg performing basic… more
    Humana (08/14/25)
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