- CVS Health (Albany, NY)
- At CVS Health , we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming ... health care. As the nation's leading health ...user feedback, and market research to enhance digital self-service, claims transparency, provider search, member portals, and mobile applications.… more
- Centene Corporation (New York, NY)
- …and Medicare members, as well as to individuals and families served by the Health Insurance Marketplace. Looking for a compelling opportunity to move beyond ... 28 million members as a clinical professional on our Medical Management/ Health Services team. Centene is a...Centene offers a comprehensive benefits package including: competitive pay, health insurance , 401K and stock purchase plans,… more
- Humana (Albany, NY)
- …us put health first** The Corporate Medical Director (CMD) relies on medical background to review health claims and preservice appeals. The Corporate ... Qualifications** + Medical utilization management experience + Working with health insurance organizations, hospitals and other healthcare providers, patient… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …or Bachelor's degree with a minimum of two years' experience in long term care insurance claims processing. + Must have the ability to review and interpret ... Insured, Insured's family, care providers, and adjudication of the claims . All work is directed under the terms and...the total rewards package may include participation in group health and/or dental insurance , retirement plan, wellness… more
- Saratoga Hospital (Saratoga Springs, NY)
- …strategies through analysis and assessment of data intended to enhance the overall health of the Saratoga Hospital Medical Group patient population. The ... the primary responsibility of coordinating quality improvement activities, utilizing insurance company guidelines and assessing gaps in care and...meetings. + Work with patient lists, gap lists, sourced health data and medical records in your… more
- SUNY Upstate Medical University (Syracuse, NY)
- …compliance with current healthcare regulations and payer requirements. + Prepare and submit claims to insurance companies, following up on unpaid or denied ... Proficient in medical terminology and anatomy. + Strong understanding of insurance guidelines, including Medicare and Medicaid. + Proficient in EPIC systems for… more
- Humana (Albany, NY)
- …us put health first** The Corporate Medical Director relies on medical background and reviews health claims and preservice appeals. The Corporate ... + Medical utilization management experience, + working with health insurance organizations, hospitals and other healthcare providers, patient… more
- Independent Health (Buffalo, NY)
- …Six (6) months experience handling self-funded pharmacy calls or working for a health insurance company or physician's office interacting with pharmacies; OR ... as needed. B. Technical Proficiency + Maintain technical knowledge regarding Independent Health and PBD pharmacy contracts and benefits and working knowledge of… more
- Sedgwick (New York, NY)
- …and relatively complex National Account. **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Examines insurance policies, claims , and other records to determine ... insurance coverage. + Administers and reconciles complex catastrophic claims for property. + Interviews, telephones, or corresponds with claimant(s) and witnesses… more
- Arnot Health (Elmira, NY)
- …premiums due from the employee.* 11. Responsible for the filing of life insurance claims and assisting employees and/or beneficiaries. 12. Communicates with ... Is responsible for employee benefit and retirement administration to include medical , dental, vision, life insurance , short-and long-term disability, and… more