- Trinity Health (Albany, NY)
- …Risk Adjustment Coding Specialist -St. Peter's Health Partners - Full-time - Remote **POSITION PURPOSE:** The Risk Adjustment Coding Specialist works in a team ... diagnoses assigned in the EHR by the providers to claims being submitted for their services. Using billing system...to sit for long periods of time. . 100% remote but if local may include some travel to… more
- UNUM (Albany, NY)
- …Rehabilitation. 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
- Datavant (Albany, NY)
- …fields would be beneficial: Data Entry, Medical Records, Health Care, Insurance Claims Processing and Proof Reading/Editing of Documents + Ability to stay organized ... of its components, pregnancy or pregnancy-related medical conditions, and/or religion. For remote work, this position requires that you provide a high-speed internet… 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
- Mount Sinai Health System (New York, NY)
- …**Director Pre Appeals Management-HSO Appeals Management -Corporate 42nd Street-Full-Time-Days - Remote ** The Director, Pre Appeals Management is a strategic ... + Insurance: Understanding of benefits verification, coverage determination, or claims workflows + Fintech/IT: EPIC **Describe Work Environment** Office-based May… more
- Molina Healthcare (Rochester, NY)
- …affordably. Performs research, financial modeling, and analysis of complex healthcare claims data (medical, pharmacy and ancillary) to deliver practical, actionable ... financial and even clinical insights to focus high priorities and attack underperforming and problematic contracts. Supports multi-dimensional pricing strategies to drive down total cost of care and minimize variation in cost by leveraging value-based care… more
- Molina Healthcare (Yonkers, NY)
- …supervised learning and rule-based logic to detect potentially incorrectly paid claims . + Contribute to improve data quality, perform data audits, identify ... discrepancies and resolve issues. + Support the identification of opportunities for operational improvement or growth based on analytical findings. + Areas of exposure may include: + Economics/Finance + Data Analysis / Science + Fraud, Waste, and Abuse… more
- Molina Healthcare (Buffalo, NY)
- …affordably. Performs research, financial modeling, and analysis of complex healthcare claims data (medical, pharmacy and ancillary) to deliver practical, actionable ... financial and even clinical insights to focus high priorities and attack underperforming and problematic contracts. Supports multi-dimensional pricing strategies to drive down total cost of care and minimize variation in cost by leveraging value-based care… more
- University of Rochester (Rochester, NY)
- …open account receivables to successful closure. Responsible for an effective claims follow-up to obtain maximum revenue collection. Researches, corrects, resubmits ... claims , submits appeals and takes timely and routine action...staff. Location: Rochester Tech Park (RTP), Gates, NY - Remote options available after in-person training. Occasional onsite meetings… more
- University of Rochester (Rochester, NY)
- …open account receivables to successful closure. Responsible for an effective claims follow-up to obtain maximum revenue collection. Researches, corrects, resubmits ... claims , submits appeals and takes timely and routine action...**LOCATION** + Rochester Tech Park (RTP), Gates, NY + Remote options available after in-person training. + Occasional onsite… more