• Director, Global Clinical Development

    Otsuka America Pharmaceutical Inc. (Albany, NY)
    …research programs and protocols for OPDC products under good clinical practices (GCP). Remote candidates will be considered for US candidates. This position may also ... offered money for equipment fees or some other application processing fee, even if claimed you will be reimbursed,...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more
    Otsuka America Pharmaceutical Inc. (04/17/25)
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  • Medicaid Provider Hospital Reimbursement…

    Humana (Albany, NY)
    …of experience researching MS-DRG, APR-DRG and/or EAPG grouper logic + Experience processing or reviewing facility claims + Prior professional experience ... closely with IT, the pricing software vendor, CIS BSS, Medicaid operations, claims operations, and other business teams involved in the administration of Medicaid… more
    Humana (05/29/25)
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  • Senior Software Engineer- COBOL coding

    Humana (Albany, NY)
    …team at Humana is essential in delivering core services through effective claims processing and management solutions. This position involves coding software ... lacking ongoing interruptions to protect member PHI / HIPAA information. \#LI- Remote ​ **Social Security Task** Humana values personal identity protection. Please… more
    Humana (05/16/25)
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  • Team Associate

    Centene Corporation (Queens, NY)
    …of related experience. Thorough knowledge of customer service, utilization review or claims processing practices in a managed care environment and operation ... in keeping with the prior authorization list. + Research claims inquiry specific to the department and responsibility. +...plus holidays, and a flexible approach to work with remote , hybrid, field or office work schedules. Actual pay… more
    Centene Corporation (04/23/25)
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  • System Programmer II

    NASCO (Albany, NY)
    …construction results + Implements system enhancements and fixes to maximize our processing system's (NPS) performance + Applies sound judgment, and discretion in ... Researches and resolves model office and production issues so claims can be paid accurately and timely + Maintains...UiPath **Working Conditions:** + **Location** : Home office / Remote + **Travel** : Occasional travel for meetings to… more
    NASCO (05/06/25)
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  • Chart Procurement Specialist

    MVP Health Care (Tarrytown, NY)
    …education and complimentary experience preferred. + One year experience in a claims processing , health care/provide office setting or related position required. ... records off those systems. + Works with IT on remote access to provider offices. + Scans, downloads, merges...and other records. + Completes provider payment and invoice tracking/ processing . + Works with MVP Provider Relations Representatives as… more
    MVP Health Care (05/29/25)
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  • Reimbursement Sr Analyst

    Intermountain Health (Albany, NY)
    …centralized office function. and other projects as assigned. **This is a 100% remote position** **however, currently we are unable to consider candidates for ... remote opportunities in the following states: California, Hawaii, Illinois,...and budgeted contractual allowances and variances, monitoring of individual claims (logs), etc.). Interacts with HIM, PAS, and hospital… more
    Intermountain Health (05/28/25)
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  • Medical Analytics Data Engineer

    Pfizer (New York, NY)
    …for analytical models. + Identify data inputs needed to conduct analytics (eg, claims data for unmet need analysis) + Gather, prepares, and maintains datasets ... collaboration with data mgmt. lead and ensure accurate collection, storage, and processing of data within team. + Enhance data infrastructure for greater scalability… more
    Pfizer (05/17/25)
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  • Appeals and Grievances Clinical Specialist - RN,…

    Healthfirst (NY)
    …+ Experience in clinical practice with experience in appeals & grievances, claims processing , utilization review or utilization management/case management. + ... This position is 100% Remote . We are hiring for the following schedules listed below:** **EST Schedule** **Wednesday through Saturday, 10-hour shift, 7am-5:30pm**… more
    Healthfirst (05/29/25)
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  • Rental Territory Manager

    Caterpillar, Inc. (NY)
    …(coverage, forecasting, inventory management, rental fleet utilization, and orders and claims processing , etc.) with special emphasis on streamlining processes ... + Territory: This role covers 4 Caterpillar Dealers across the US Northeast. + Remote locations will be considered on a case-by-case basis for this role; however,… more
    Caterpillar, Inc. (05/28/25)
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