- Humana (Albany, NY)
- …or FSA designation, MAAA + 2+ years of actuarial experience in health insurance and/or medical claims analytics + Proficiency in data analysis and one or more ... Qualifications** + Strong communication skills + Strong working knowledge of healthcare claims as it relates to trend analytics, total cost of care management,… more
- Rochester Regional Health (Rochester, NY)
- …SUMMARY The Billing and Reimbursement Specialist is responsible for timely processing of medical claims for DRUGSCAN. RESPONSIBILITIES + Process current and aged ... obtain claim processing status and clarification regarding un-responded or partially responded claims . + Analyze and report trends based on data analysis. +… more
- Molina Healthcare (Rochester, NY)
- …as the professional scope of a Payment Integrity Clinician. This includes assessing medical documentation, itemized bills, and claims data to ensure appropriate ... tracking cost containment initiatives through comprehensive clinical and financial analysis of claims data, medical documentation, and itemized bills. + Leads… more
- Mount Sinai Health System (New York, NY)
- …high school diploma/GED plus 2 years of relevant experience + 2 years experience in medical billing or health claims , with experience in IDX billing systems in a ... methodologies. 5. May perform specialty coding for services and medical office visits and review physician coding and provide...accounts via online work file and/or hard-copy reports; checks claims status, re-submits claims , and writes appeal… more
- JPMorgan Chase (New York, NY)
- …Morgan Health team. In this role, you will leverage your expertise in medical and pharmaceutical claims data, survey data, biometrics data and industry-standard ... on health care data + Subject matter expertise in medical and pharmaceutical claims data, including familiarity...Subject matter expertise in medical and pharmaceutical claims data, including familiarity with common coding standards and… more
- CDPHP (Albany, NY)
- …The Document Service Representative will work closely with Member Services, Provider Services, Claims Operations, and Medical Affairs to resolve claims ... performing a detailed mail sort, batch preparation, and scanning of all incoming claims and correspondence to facilitate and ensure compliance with all New York… more
- Mount Sinai Health System (New York, NY)
- …+ High School diploma/GED. + Three years of experience in a medical billing or insurance claims environment. **Responsibilities** 1. Reviews and ... resolves moderate to complex pre-billing issues on insurance claims submissions. 2. Works and resolves moderate to complex...Sinai Health System is one of the largest academic medical systems in the New York metro area, with… more
- Norstella (Albany, NY)
- …will be pivotal in integrating diverse data sources, including laboratory data, electronic medical records (EMR), claims data, and social determinants of health ... goals. + Drive the integration of diverse data sources, including lab, EMR, claims , and SDoH data, to create comprehensive and actionable datasets + Identify and… more
- New York State Civil Service (Endicott, NY)
- NY HELP Yes Agency Insurance Fund, State Title Claims Service Representative 1/Trainee 1/2 - NY HELPS Occupational Category Other Professional Careers Salary Grade ... NY Zip Code 13760 Duties Description Under the general supervision of a Claims Services Representative 2, the incumbent will oversee all aspects of workers'… more
- AON (Garden City, NY)
- Aon is looking for a Claims Specialist II Do you have experience in claims adjudication and enjoy resolving issues for clients? If you'd like to grow your ... helping colleagues reach their career goals. Responsibilities: + Review and service claims in accordance with plan provisions. + Conduct thorough investigation of… more