- Molina Healthcare (Rochester, NY)
- …accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims databases. Synchronizes ... life cycle + Gains a deep understanding of Molina claims life cycle and all processes that affect ...claims life cycle and all processes that affect claims payment + Develops and maintain standards and best… more
- Humana (Albany, NY)
- …documentation + Have a range of subject matter expertise relative to both Claims Administration & Payment Integrity (CAPI) and Humana as well as Medicaid ... and the impacted business areas While this role 100% remote , candidates that reside within 50 miles of Louisville,...in office as needed. All others will remain 100% virtual/ remote . **What Humana Offers** We are fortunate to offer… more
- Molina Healthcare (Syracuse, NY)
- …leadership and direction to MMS Operational Units management staff (eg, Claims Processing, Provider Services, Provider Enrollment, Finance, Managed Care Provider ... equivalent experience **Required Experience** 3 years supervision/management experience in Claims Processing or Provider Services environment and/or any high volume… more
- Molina Healthcare (Albany, NY)
- …you keep complaint data synchronized across appeals & grievances, enrollment, claims , pharmacy, and quality functions. You surface systemic issues, steer partners ... Mastery * Track record coordinating cross-functional action plans with Enrollment, Claims , Pharmacy, Network, and Member Services * Hands-on experience maintaining… more
- Sedgwick (Albany, NY)
- …Fortune Best Workplaces in Financial Services & Insurance Licensed Auto Insurance Agent- Remote **_Schedule:_** Monday - Friday 9:00 AM - 5:30 PM **Central time (for ... for this or other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The… more
- Sedgwick (New York, NY)
- …Workplaces in Financial Services & Insurance Client Services Director | REMOTE | Casualty/Workers Compensation Experience required + **Program management experience ... for this or other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The… more
- NTT DATA North America (New York, NY)
- …apply now. We are currently seeking a Specialty Seller BPO, Banking and Financial Services( Remote ) US to join our team in New York, New York (US-NY), United States ... solve process challenges related to **F&A, Customer Experience, KYC, Claims , HR, Procurement** , or **industry-specific processes** . +...for specific roles. The starting pay range for this remote role is $170,000 - $280,000 . This range… more
- Sanofi Group (New York, NY)
- **Job Title:** Associate Director, National Account Operations CVS - US Remote **Location:** Remote /Field Based **About the Job** The **Associate Director, ... knowledge of the US healthcare system, including formulary operations, claims adjudication, specialty pharmacy networks, and contract performance tracking. We… more
- Molina Healthcare (Syracuse, NY)
- …executive decision-making + Mine and manage information from large data sources. + Analyze claims and other data sources to identify early signs of trends or other ... of provider reimbursement changes + Provide data driven analytics to Finance, Claims , Medical Management, Network, and other departments to enable critical decision… more
- Mount Sinai Health System (New York, NY)
- …and accurate integration of data from various external sources, including wholesalers, claims systems, and financial platforms. + Develop complex SQL logic to join, ... transform, and reconcile data from Epic, QS1, Oracle Cloud, 340B claims data, and wholesaler purchase feeds. + Support 340B program reporting by building custom… more