- Capital One (New York, NY)
- …our systems and platforms that power Fraud defenses and Fraud & Disputes claims processing + Partner cross-functionally with client, cloud infrastructure, and ... Sr. Distinguished Engineer - Fraud Technology ( Remote -Eligible) As a Sr. Distinguished Engineer at Capital...the company _Capital One is open to hiring a Remote Employee for this opportunity._ **Basic Qualifications** + Bachelor's… more
- Cognizant (Albany, NY)
- …use Optum PPS configuration. + Demonstrate strong understanding of healthcare claims processing , provider contracts, fee schedules, and benefits configuration. ... **Healthcare Product Consulting - NetworX Consultant ( Remote )** **Job Summary** : The NetworX Product Consultant is responsible for providing customers with… more
- Molina Healthcare (Albany, NY)
- …applicants. * Completes data corrections in the credentialing database necessary for processing of recredentialing applications. * Reviews claims payment systems ... to determine provider status, as necessary. * Completes follow-up for provider files on 'watch' status, as necessary, following department guidelines and production goals. * Reviews and processes daily alerts for federal/state and license sanctions and… more
- University of Rochester (Rochester, NY)
- …proper coding regulations and contracts. Prepares and maintains billing for these claims daily. Assists the PFS Revenue Cycle Manager and multiple department ... and problem-solving. Assist in problem identification and resolution. 10% Ensure timely processing of credit balances when overpayments occur. + Ensure timely … more
- Molina Healthcare (Buffalo, NY)
- …or team leadership experience + 10 years' work experience preferable in claims processing environment and/or healthcare environment + Strong knowledge of ... SQL 2005/2008 SSRS and Power BI report development + Familiar with relational database concepts, and SDLC concepts **Preferred Education** + Masters' Degree in Finance, Economics, Math, Computer Science, Information Systems, or related field. + Preferred… more
- Molina Healthcare (NY)
- …encounter processes, provider and contract configuration, provider information management, claims processing and other related functions. **Preferred Education** ... Bachelor's Degree **Preferred Experience** * Six years proven analytical experience within an operations or process-focused environment. * Previous audit and/or oversight experience. To all current Molina employees: If you are interested in applying for this… more
- University of Rochester (Rochester, NY)
- …as to why claims are not paid and steps necessary for processing /payment. - - Initiate collection phone calls to insurance companies to determine reason for ... 7:30 AM-4 PM Responsibilities Location Rochester Tech Park (RTP), Gates, NY - Remote options available after in-person training. Occasional onsite meetings / work at… more
- University of Rochester (Albany, NY)
- …through telephone calls, payer website, and written communication to ensure accurate processing of claims . Collaborate with appropriate departments to generate a ... place where all can thrive. **Job Location (Full Address):** Remote Work - New York, Albany, New York, United...rejection or denial codes as they pertain to claim processing and coding. Escalates system issues preventing claims… more
- Cardinal Health (Albany, NY)
- Hybrid or remote position Schedule: Monday - Friday, 8:00am -.... + Acts as a subject matter expert in claims processing . + Manages billing queue as ... things done. **The Accounts Receivable Specialist II is responsible for processing insurance claims and billing. They will work within the scope of… more
- Cardinal Health (Albany, NY)
- Hybrid or remote position Schedule: Monday - Friday, 8:00am -...appropriate. + Acts as a subject matter expert in claims processing . + Processes claims : ... administration customer and vendor pricing, rebates, billing (including drop-ships), processing chargebacks and vendor invoices and developing and negotiating… more