- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- EFI Global (Rochester, NY)
- …in one of the following areas: workers compensation, liability and disability claims management + Strong understanding of client location coding parameters, banking ... methodology, and claims operating systems + Excellent oral and written communication,...benefits package is offered including but not limited to, medical , dental, vision, 401k and matching, PTO, disability and… more