- Citigroup (Getzville, NY)
- …entries + Manage his/her aging and claim portfolio + Maintain up to date and accurate audit trails for all claims + Be prepared for weekly aging sessions to ... & Derivatives Associate Analyst is responsible for investigating and settling compensation claims internally and externally for the EMEA and NA Capital Market… more
- Amazon (New York, NY)
- …- Bachelor's degree - 5+ years of program management experience in insurance and claims programs - 10+ years of compliance audit or Risk Management experience ... Description The Corp Auto Claims Management & Operations group within Amazon's Global...compensation package, in addition to a full range of medical , financial, and/or other benefits. For more information, please… more
- Highmark Health (Albany, NY)
- …or Medical Review Committee. + Engages in delivery of audit results and overpayment negotiations.Responsible for recovery/ savings of misappropriated funds paid ... for proactive and investigative purposes to comply with internal audit and regulatory requirements. **ESSENTIAL RESPONSIBILITIES** + Performs investigations into… more
- Kaleida Health (Buffalo, NY)
- …(DRG) assignment, proper reimbursement and quality measure/metrics. Assists with the audit analysis, trending, and presentation of audit /review findings, ... plan and execute quality audits, perform data analysis, trending, presentation of audit /review findings, and identify opportunities and develop a training plan for… more
- CDPHP (Albany, NY)
- …team's delivery of the analysis, maintenance, and configuration of CDPHP's core claims systems and applications application systems, as well as modifying existing ... state and federal mandates to ensure the successful configuration of CDPHP's core claims systems and any integrated systems. The Configuration Analyst III will be… more
- Ascend Autism (Hawthorne, NY)
- …ensure all questions are answered in a timely and professional manner + Regularly audit medical record documentation to verify the accuracy and completeness + ... payors and patients. Roles & Responsibilities: + Submit initial claims on a weekly basis + Follow-up, and re-submit...experience of using ICD and/or CPT coding systems and medical compliance regulations + Certified Revenue Cycle Specialist (CRCS)… more
- Independent Health (Buffalo, NY)
- …include continuous review of the accounts receivable aging report and ensuring all open claims are paid in a timely fashion. The coordinator will analyze data to ... payables or business to business account servicing required. Pharmacy and pharmaceutical claims knowledge preferred. + Experience working with online claims … more
- Otsuka America Pharmaceutical Inc. (Albany, NY)
- …with Sales and Marketing on sample allocation and planning. + Support audit readiness and compliance reviews. **Operational Efficiency & Field Partnership** + ... with states and local laws. **Company benefits** : Comprehensive medical , dental, vision, prescription drug coverage, company provided basic...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more
- Mohawk Valley Health System (Utica, NY)
- …Department: MEDICAL GROUP ADMINISTRATION Job Summary The Supervisor Coding Audit and Education is responsible for overseeing medical coding accuracy, ... compliance, and education initiatives within the Medical Group. This role supervises Coding Auditor & Educators and conducts coding audits, ensuring adherence to… more
- Molina Healthcare (Syracuse, NY)
- …the likelihood of a formal appeal being submitted. + Independently re-evaluates medical claims and associated records by applying advanced clinical knowledge, ... programs supported by the plan such as Utilization Review, Medical Claims Review, Long Term Service and...+ Active and unrestricted Certified Clinical Coder + Certified Medical Audit Specialist + Certified Case Manager… more