- Centene Corporation (Queens, NY)
- …including a fresh perspective on workplace flexibility. **Position Purpose:** The Clinical Quality Assurance RN will work in various capacities to review, ... clinical documentation submitted by the Intake Specialist. The Clinical Quality Assurance RN will review for to...10 codes, medical abbreviations, medications. Experience in medical records review, claims processing or utilization… more
- Axis (New York, NY)
- …opportunities the increased use of internal Severity and Coverage resources. + Compliance & Quality Assurance - Comply with best practices measured by monthly ... taking part in the selection process. **Job Description: Senior Claims Specialist** AXIS is seeking a Senior Claims...Quality Assurance and Management Initiated Audit scores… more
- Cognizant (Albany, NY)
- …+ 1 year of Facets experience. + Experience in the analysis and processing of claims for payments, utilization review/ quality assurance procedures. + Must be ... is required. **Travel:** None required **About the role:** As Claims Processor (with Facets), you will be responsible for...HCFA paper or EDI information. * Responsible for reviewing medical records when necessary to determine if service rendered… more
- General Dynamics Information Technology (Menands, NY)
- …Trust/Other Required:** None **Job Family:** Professional Engineering **Skills:** Healthcare Claims , Quality Assurance (QA),Structured Query Language (SQL) ... determine the possibility of adding test cases to the Quality Assurance Regression (QAR) baseline + Add...REQUIRED TECHNICAL SKILLS: + 837 (I, P and D) Medical Claims testing experience + Knowledge of… more
- Otsuka America Pharmaceutical Inc. (Albany, NY)
- …Summary** We are seeking an experienced and dynamic Executive Director of R&D Global Quality to join our team. This pivotal role will be responsible for leading a ... global team focused on R&D Quality . This global role includes direct reports in the...years of experience in a FDA regulated pharmaceutical and/or medical device industry environment + Strong knowledge of current… more
- Claxton-Hepburn Medical Center (Carthage, NY)
- …detail and accuracy as it pertains to the documentation of information + Maintaining quality assurance and compliance with all regulatory agencies + CCPT and ... Internal Posting Dates: June 13, 2025-June 20, 2025 Medical Records - Medical Records Coder...to determine the hospital database and reimbursement of hospital claims . EDUCATION: Required: + High school diploma or equivalent… more
- Evolent (Albany, NY)
- …of experience in technical quality assurance and database testing, medical benefits, provider, enrollment, and / or claims data. + Demonstrable ... for the culture. **What You'll Be Doing:** Job Description **Analyst, Integration Quality ** Integration testing in the healthcare ecosystem requires complete end to… more
- Intermountain Health (Albany, NY)
- …regulatory guidelines and established departmentalpolicies and procedures, objectives, quality assurance program, safety, environmental and infectioncontrol ... regulatory guidelines and established departmental policies and procedures, objectives, quality assurance program, safety, environmental and infection control… more
- Sedgwick (Albany, NY)
- …of a client Disability Pension Board + Review of identified appeal cases for quality assurance purposes + Voting member to determine if eligibility requirements ... state regulations, and client service requirements and assure efficient, cost effective, quality program delivery for medical and disability management. +… more
- Centene Corporation (New York, NY)
- …activities. + Performs medical review activities pertaining to utilization review, quality assurance , and medical review of complex, controversial, or ... Medical Director to direct and coordinate the medical management, quality improvement and credentialing functions...to providers that would improve utilization and health care quality . + Reviews claims involving complex, controversial,… more