- Molina Healthcare (Yonkers, NY)
- …across a wide range of subrogation case types-including automobile-related claims (eg, no-fault/PIP), workers' compensation, general liability, medical malpractice, ... Medicaid, Medicare, and Marketplace populations. + Collaborate with legal, claims , provider relations, finance, and compliance departments to ensure coordination… more
- Molina Healthcare (Yonkers, 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
- Otsuka America Pharmaceutical Inc. (Albany, NY)
- …fee, even if claimed you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to exercise caution when you receive ... legitimate job opportunity. Scammers may also send offers or claims from a fake email address or from Yahoo,...will not be held liable or responsible for any claims , losses, damages or expenses resulting from job recruiting… more
- TEKsystems (New York, NY)
- 100% REMOTE JOB OPPORTUNITY FOR HEDIS ABSTRACTORS - MUST HAVE PRIOR HEDIS EXPERIENCE EQUIPMENT PROVIDED THIS JOB OPPORTUNITY IS A 3 MONTH CONTRACT MONDAY - FRIDAY ... + Responsibilities include retrieving medical records with clinical accuracy using remote access to Electronic Medical Record Systems while meeting daily… more
- Pearl Interactive Network (Albany, NY)
- **Pearl Interactive Network is sourcing Seasonal Remote Customer Service Representatives.** The **Customer Service Representative** is responsible for providing ... + Navigate pre-scripted responses, read them verbatim to provide basic and claims -specific information, and ensure callers receive accurate details. + Perform other… more
- Centene Corporation (New York, NY)
- …to providers that would improve utilization and health care quality. + Reviews claims involving complex, controversial, or unusual or new services in order to ... reimbursement, paid time off plus holidays, and a flexible approach to work with remote , hybrid, field or office work schedules. Actual pay will be adjusted based on… more
- Molina Healthcare (NY)
- …organized and analytical thinking. Experience with Medicare/Medicaid, MS 365 and familiarity with claims is highly preferred. The Case Manager must be able to work ... encouraged to apply. Further details to be discussed during our interview process. Remote with 10% travel to member's home or facility Work schedule Monday through… more
- CVS Health (Albany, NY)
- …data, user feedback, and market research to enhance digital self-service, claims transparency, provider search, member portals, and mobile applications. + Identify ... regulated industry. + Strong knowledge of healthcare payer operations ( claims , eligibility, enrollment, prior authorization, provider networks). + Experience working… more
- Molina Healthcare (Albany, NY)
- …and timely validation and maintenance of critical provider information on all claims and provider databases. Staff ensure adherence to business and system ... not limited to, Configuration, Business Systems, Encounters (inbound and outbound), Claims , Provider Services and Contracting. * Identifies issues, resolves problems… more
- UNUM (Albany, NY)
- …Summary:** This position is responsible for providing expert medical analysis of claims files (or underwriting applications) across Unum US product lines. The ... and internal workflow standards as set forth in the Benefits Center Claims Manual, underwriting manual, and associated documentation. The incumbent adheres to… more
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