- Molina Healthcare (Rochester, NY)
- …recoveries in a managed care or payer environment. + In-depth knowledge of medical and hospital claims processing, including CPT/HCPCS, ICD, and modifier usage. ... for Medicare & Medicaid Services (CMS) and the Affordable Care Act (ACA). + Medical Coding certification. To all current Molina employees: If you are interested in… more
- WTW (New York, NY)
- …Risk, including adjustments for model limitations, near-term climate conditions, and claims experience. + Working with clients, jointly with other Willis commercial ... following (eligibility requirements apply): + **Health and Welfare Benefits:** Medical (including prescription coverage), Dental, Vision, Health Savings Account,… more
- World Insurance Associates, LLC. (Syosset, NY)
- …support and manage employee benefits for clients, with a focus on: Medical , Dental, Vision, Life, AD&D, Long-term Disability, Short-Term Disability, and Voluntary ... cases + Create monthly financial reporting packages including detailed premium, claims , membership, commission, and cash reconciliation information + Create weekly,… more
- Highmark Health (Albany, NY)
- …data. This position routinely utilizes data including, but not limited to: medical /surgical physician and institutional claims and encounters, clinical data, ... robust analytical and financial analysis capability for Highmark's pharmacy and medical benefit specialty drug management programs. Furthermore, the incumbent will… more
- City of New York (New York, NY)
- Job Description APPLICANTS MUST BE PERMANENT IN THE ADMINISTRATIVE STAFF ANALYST CIVIL SERVICE TITLE, OR BE PERMANENT IN A COMPARABLE TITLE ELIGIBLE FOR 6.1.9 TITLE ... /Division of Accounts Receivable (DAP) comprise of Miscellaneous Contracts & Medical Payments, Employment Program Payments, the operations of Contract Agency Monthly… more
- Ross Stores, Inc. (New York, NY)
- …to promote compliance and mitigate legal exposure, while effectively managing projects/ claims \. The position will report to the Sr\. Director, Employment Law, ... options in order to facilitate business decisions and outcomes\. * Claims management: Effectively and efficiently resolve demand letters and pre\-litigation… more
- BronxCare Health System (Bronx, NY)
- …to monitor the linkage to care activities. Work with the data analyst on dissemination and poster/publication submissions. Responsibilities - Establish and maintain ... collection, analysis, implementation of and compliance with risk management and claims activities, support of and participation in Continuous Quality Improvement… more
- City of New York (New York, NY)
- …information with clinic teams to ensure transparency. - Track and manage medical records requests from MCO to obtain prior authorization approvals and claim ... reimbursement. - Review all claims CPT/ICD-10/HCPCS, payment modifiers in billing software to ensure...employee benefits or health insurance as a manager, research analyst , or underwriter, or in public health education. One… more
- Molina Healthcare (Syracuse, NY)
- …Department staff for mentoring, coaching, and analysis questions. + Reviews Pharmacy analyst work products to ensure accuracy and clarity. + Reviews regulatory ... for strategic analysis, profitability, financial analysis, utilization patterns and medical management. + Interfaces and maintains positive interactions with… more
- BronxCare Health System (Bronx, NY)
- …collection, analysis, implementation of and compliance with risk management and claims activities, support of and participation in Continuous Quality Improvement ... implementation - Coordinate and supervise the maintenance, monitoring, recording patients' medical records, follow-up, and lab data. - Collaborate with various teams… more