- Albany Medical Center (Albany, NY)
- …of America) Salary Range: $65,102.17 - $100,908.37 Under the direction of the Director of Pharmacy the Pharmacy Revenue Integrity Auditor will serve as a pharmacy ... billing practices by reviewing patient records, medication orders, and insurance claims to identify and correct potential pharmaceutical billing errors. They are… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …external standards set by regulatory and accreditation entities. Refers appropriate cases to the Medical Director for review. Refer to and work closely with Case ... identifies and refers potential quality of care and utilization issues to Medical Director . + Utilizes appropriate communication techniques with members and… more
- AON (New York, NY)
- …and account executives to secure new client relationships as well as the management of ongoing US health and benefits client relationships and delivery of consulting ... position will have frequent interactions with the client Human Resource/Benefit Director for the delivery of benefits consulting services. Responsibilities include… more
- Kelly Services (Rochester, NY)
- …exception, and medical necessity reviews + Route cases to pharmacist/ medical director for final determination, as directed + Issue verbal ... processing and review of prior authorization requests for both pharmacy and medical specialty drug reviews as permitted by law. Reviews are conducted in… more
- BronxCare Health System (Bronx, NY)
- …participation includes data collection, analysis, implementation of and compliance with risk management and claims activities, support of and participation in ... and implementation of educational programs for Denial Prevention and Management . Responsibilities - Establish and maintain positive relationships with patients,… more
- Jacobs (Garden City, NY)
- At Jacobs, our Program Management and Construction Management (PM/CM) team works seamlessly with clients by delivering projects and programs to achieve our ... in a rewarding career working on ENR's #1 Construction Management -for-Fee firm, then Jacobs is where you belong. We're...on time but within budget. As the Assistant Project Director , you'll take the lead on developing and communicating… more
- Barnes & Noble (New York, NY)
- …factors permitted by law. WhatYouDo: * Coordinate Proposition 65 claims , recalls and similar, including communication, documentation, follow-up, and disposition ... of inventory as determined by Director . * Generate and review product, import, vendor and...communication skills. * Excellent organizational skills related to data management , document storage and retrieval, project ownership and time… more
- Seton Education Partners (Bronx, NY)
- …Public Charter Schools Network. This position reports directly to the Elementary School Director of Student Services and is based in the Bronx, NY. About Seton ... Network Team. The analyst directly supports campuses by monitoring the case management process for initials, annual, and re-evaluation IEP meetings. Another key… more
- MTA (Jamaica, NY)
- …public. This position provides experienced interpretation and advisement on labor- management activities, collective bargaining agreements and labor law to protect ... denial letter within time limits. Calculate the cost or liability of claims . Negotiate stipulations of settlement where appropriate. Analyze cases and make decisions… more
- Evolent (Albany, NY)
- …of 1 years of experience in technical quality assurance and database testing, medical benefits, provider, enrollment, and / or claims data. + Demonstrable ... most valuable defects. The IQA reports to a associate director or a manager. One or many IQAs may...in detail + provide summary information to stakeholders & management answering business questions + create & maintain queries… more