- Otsuka America Pharmaceutical Inc. (Albany, NY)
- …teams including providing oversight of integrated brand strategy and plans + Represents Global Medical Affairs on Copy Review governance committee + Is a core ... **Position Summary** : Reporting to the Vice President, Global Medical Affairs, the Executive Director, CNS Strategy, Global ...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more
- KPH Healthcare Services, Inc. (Syracuse, NY)
- …Summary:** Responsible for developing, improving and continuing the process billing of medical claims for specialty pharmacy facilities. Needs to communicate ... assigned tasks. Establish, manage, and communicate the process of billing medical claims for specialty facilities. **Responsibilities** **Job Duties:** +… more
- MetLife (Oriskany, NY)
- …the office once a month for office meetings Summary of Responsibilities: Review , research, and investigate pended FEGLI Life claim submission with multiple coverages ... . Identify and obtain missing information required to evaluate FEGLI life claims and input information into a Power Builder computer claim system computer… more
- University of Rochester (Albany, NY)
- …as they pertain to claim processing and coding. Escalates system issues preventing claims submission and follow-up for review and resolution. + 5% Collaborates ... individual, and internal equity considerations._ **Responsibilities:** GENERAL PURPOSE The Claims Resolution Representative III is responsible for working across the… more
- The Institute for Family Health (New Paltz, NY)
- …years of medical billing experience required + Proficiency in EPIC claims processing workflows preferred + Ability to run and interpret/analyze Crystal and EPIC ... and that processing of denials are at optimal levels + Ensure daily/weekly/monthly medical claim submission. Resolve claim and remittance file issues as needed. +… more
- Pfizer (New York, NY)
- The Oncology Field Medical Outcomes, Director is a field-based medical colleague responsible for providing therapeutic area/product expertise for a designated ... through real-world data analyses, pharmacoeconomic analyses, outcomes evaluations, and medical presentations. The responsibilities of the role are to contribute… more
- CDPHP (Albany, NY)
- …The Document Service Representative will work closely with Member Services, Provider Services, Claims Operations, and Medical Affairs to resolve claims ... required. + High school diploma or GED required. + Minimum of (1) year claims examining procedural review experience utilizing CPT-4, HCPCS, and ICD-9 codes is… more
- Access: Supports For Living (Middletown, NY)
- …the resolution of identified revenue cycle billing issues + Handling billing cycle review procedures for pre-processing (scrubbing) of weekly claims processing + ... process and achieving resolution through coordination and reconciliation + Review and work claims in the clearinghouse...well as on a collaborative team. + Knowledge of Medical Insurance programs such as Medicaid, Medicare and Dual… more
- Centene Corporation (New York, NY)
- …management, cost containment, and medical quality improvement activities. + Perform medical review activities pertaining to utilization review , quality ... recommendations to providers that would improve utilization and health care quality. + Review claims involving complex, controversial, or unusual or new services… more
- GE Vernova (Schenectady, NY)
- …project execution and ensures that commercial risks and opportunities (notably claims , change orders, vendor and insurance recoveries) are identified early, tracked, ... as negotiation. **Job Description** + Implement risk mitigation strategies + Develop claims settlement agreements + Manage and drive Contract Change Order execution… more