- Evolent (Albany, NY)
- …fostering trust, expertise and cooperation. + Extract, manage, and analyze claims and operational data using industry-standard metrics. + Process and validate ... raw unadjudicated claims data. **Qualifications Required and Preferred:** + Bachelor's degree, preferably with a quantitative major (eg actuarial, statistics, … more
- Molina Healthcare (Rochester, NY)
- …providing business process redesign, communication and change management for operations . Backend operationalization of policies, standardization of system set-up and ... to maintain and/or create business process documentation and workflows related to Core Operations functions. + Serve as liaison between Core Operations and… more
- City of New York (New York, NY)
- …technical assistance. Finance helps to ensure that programs and administrative operations have the information, analysis, funding, and technical capacity to deliver ... payments in compliance with financial policies and procedures. - Examine invoices, claims , fee collection or applications for recoupments, refunds and verify their… more
- Molina Healthcare (Rochester, NY)
- …and implementation of changes that impact the product. + Engages with operations leadership and Plan Support functions to review compliance-based issues for benefit ... care or payer environment. + In-depth knowledge of medical and hospital claims processing, including CPT/HCPCS, ICD, and modifier usage. + Strong understanding of… more
- City of New York (New York, NY)
- …technical assistance. Finance helps to ensure that programs and administrative operations have the information, analysis, funding and technical capacity to deliver ... systems and tools to support public health research and analysis to ensure claims submitted to the Grantors are accurate and timely. - Maintain research cost… more
- CVS Health (Albany, NY)
- …knowledge of configuration management tools and systems to support organizational operations . + Codes and/or writes custom configurations or extensions to tailor ... and security requirements. **Required Qualifications** + 1 year minimum of claims processing experience + Experience with system testing and post go-live… more
- RiseBoro Homecare Inc. (Brooklyn, NY)
- ESSENTIAL DUTIES AND RESPONSIBILITIES Director of Operations and Financial Management will provide direction and leadership overseeing the day-to-day financial ... Payroll, Human Resources, Risk Management and IT. In addition, Director of Operations and Financial Management will track the financial performance for all… more
- City of New York (New York, NY)
- Job Description APPLICANTS MUST BE PERMANENT IN THE ADMINISTATIVE STAFF ANALYST CIVIL SERVICE TITLE OR BE PERMANENT IN A COMPARABLE TITLE ELIGIBLE FOR 6.1.9 TITLE ... Office of Revenue Management and Development is recruiting one (1) Administrative Staff Analyst NM2 to function as a Director of Revenue Enhancement and Analysis.… more
- Highmark Health (Albany, NY)
- …with a general understanding of data flows from various corporate systems (eg, claims , billing, lab, and Rx), to solve complex issues and problems. A comprehensive ... identification and resolution activities, maintains program/system documentation and prepares/maintains operations documentation for assigned applications. + Utilize or lead… more
- City of New York (New York, NY)
- Job Description APPLICANTS MUST BE PERMANENT IN THE ADMINISTRATIVE STAFF ANALYST CIVIL SERVICE TITLE, OR BE PERMANENT IN A COMPARABLE TITLE ELIGIBLE FOR 6.1.9 TITLE ... comprise of Miscellaneous Contracts & Medical Payments, Employment Program Payments, the operations of Contract Agency Monthly Financial Report (CAMFR) Unit and the… more