- Mount Sinai Health System (New York, NY)
- …are correctly identified and collected from key carriers. + Works with payer and provider representatives to negotiate higher rates for claim payments. + ... Responds to patient and third party inquiries, researches and resolves complex claims and corrects errors. + Reviews correspondence and rejection data from insurance carriers; posts rejections and performs reconciliations. + May transfer secondary balances to… more
- Centene Corporation (New York, NY)
- …management activities to ensure compliance with current state, federal, and third-party payer regulators + Provides and/or facilitates education to members and their ... families/caregivers on disease processes, resolving care gaps, healthcare provider instructions, care options, referrals, and healthcare benefits + Provides feedback to leadership on opportunities to improve and enhance care and quality delivery for members in… more
- BGB Group (New York, NY)
- …offers a wide range of services, including advertising, medical education, payer marketing, and consulting services. Known for excellence and professionalism, we're ... hired as strategic and creative partners by our biopharmaceutical clients to drive category/brand awareness and growth. Position Overview The Digital Production Artist is responsible for preparing projects for development and implementing updates and revisions… more
- Highmark Health (Buffalo, NY)
- …control frameworks, and assessment methodologies, particularly as applied to healthcare ( payer and provider) business processes + Knowledge of relevant regulatory ... guidelines, vendor management, sourcing and procurement, and completing assessments of vendors + Excellent resource and project planning capabilities, decision making skills, history of results-oriented delivery, and effective team building across a… more
- Mount Sinai Health System (New York, NY)
- …forms 27. Maintains a working knowledge of New York State third party payer eligibility requirements for private and hospital billing 28. Utilizes and understands ... basic medical terminology; able to complete visit encounter forms and enters ICD10-CM and CPT information into computerized systems as appropriate 29. Assists in training, orientation and education of entry level and or/float staff **About Us** **Strength… more
- IBM (New York, NY)
- …issues at the enterprise level, particularly in healthcare provider, payer , pharmaceutical, and life sciences organizations. **Required technical and professional ... expertise** * 7+ years in related technical roles, with 2+ years leading the development of modern data architecture, preferably in a consulting capacity, with experience in Automotive data environments * Extensive knowledge of operationalizing data lakes and… more
- Centene Corporation (New York, NY)
- …management activities to ensure compliance with current state, federal, and third-party payer regulators + Provides and/or facilitates education to members and their ... families/caregivers on disease processes, resolving care gaps, healthcare provider instructions, care options, referrals, and healthcare benefits + Partners with leadership team to improve and enhance care and quality delivery for members in a cost-effective… more
- Albany Medical Center (Albany, NY)
- …proper consents from patient proxies. + Be knowledgeable of and adhere to payer requirements for referrals and authorization within the scope of the specialty they ... are assigned. + Schedule follow up appointments, referrals and prior authorization for patient schedule visits as needed. + Communicate professionally and timely with all parties, including providers, patients, clinical care team, and insurance company +… more
- Trinity Health (Syracuse, NY)
- …Completes initial and follow up case reviews on all patients as dictated by payer and status. + Uses Interqual and Indicia/MCG software and Physician Advisors to ... determine appropriate patient status/level of care and ensure timely transition of care from admission to discharge. + Follows Medicare guidelines and industry standards to ensure the proper patient class is assigned. + Leads daily SNAP huddles and works… more
- Centene Corporation (New York, NY)
- …area or equivalent experience. 5+ years of experience in claim processing payer support services in healthcare, preferably with Medicare, Medicaid or equivalent ... business experience. Ability to deal with abstract and concrete variables and apply principles of logic or scientific thinking to define problems, collect data, establish facts, and draw valid conclusions. Previous experience as a lead in a functional area,… more