- City of New York (New York, NY)
- …PRINCIPAL ADMINISTRATIVE ASSOCIATE CIVIL SERVICE TITLE The Office of Revenue Management and Development (ORMD)/The Bureau of Case Integrity & Eligibility ... (1) Principal Administrative Associate II to function as an Eligibility Verification Specialist in its Eligibility Verification Division, who will: - Work on various… more
- Molina Healthcare (Syracuse, NY)
- …the Molina Healthcare provider network consists of providers that meet all regulatory and risk management criteria to minimize liability to the company and to ... credentialing database necessary for processing of recredentialing applications. * Reviews claims payment systems to determine provider status, as necessary. Ongoing… more
- City of New York (New York, NY)
- …that had not previously been recognized. The Office of Revenue Management and Development (ORMD)/Bureau of Case Integrity and Eligibility Verification (BCIEV) ... (1) Principal Administrative Associate II to function as Field Eligibility Verification Specialist in its Case Integrity and Eligibility Division, who will: - Review… more
- ThermoFisher Scientific (Rochester, NY)
- …and regulations (USP, ISO 10993, ISO 13485, IVDR, MDR). + Experience with risk management principles (ISO 14971) and drafting protocols, reports, and procedures ... providing clear rationale and documentation. + Support material change risk assessments and verify product claims align...material change risk assessments and verify product claims align with global industry standards (ISO 10993, USP,… more
- Excelsior Orthopaedics Group (Amherst, NY)
- …based on pts insurance coverage. Obtains authorizations when necessary. + Inventory management - Assists to ensure adequate supply of all DME products; responsible ... for recording all DME products dispensed via inventory management system. + Responsible for charge entry for all DME E-superbills including satellite offices and… more
- Molina Healthcare (Albany, NY)
- …the Molina Healthcare provider network consists of providers that meet all regulatory and risk management criteria to minimize liability to the company and to ... credentialing database necessary for processing of recredentialing applications. * Reviews claims payment systems to determine provider status, as necessary. *… more
- MVP Health Care (Schenectady, NY)
- …Documentation Expert Outpatient), Healthcare Anti-Fraud Associate (HCAFA), CRS (Certified Risk Specialist ). + Familiarity with platforms like Cotiviti, ... management or equivalent experience. + Deep expertise in claims processing, coding, reimbursement methodologies, and fraud prevention. + Proven success… more
- City of New York (New York, NY)
- …the Senior Executive Director will also be a subject matter expert in processing VA claims for Veteran benefits and supervising staff on how to process VA claims ... efficiently completed and submitted. Ensure Veterans who have been identified as high- risk through DVS health screeners are connected to mental health resources.… more
- Axis (Alfred, NY)
- …Definition of market strategies and business plans + *Portfolio management : Management of portfolio, exposure and risk accumulation control, monitoring of ... We stand apart for our outstanding client service, intelligent risk taking and superior risk adjusted returns...selection process. **AXIS Re** AXIS Re is a global Specialist Reinsurance Company dedicated to Casualty, A&H, Credit and… more
- Highmark Health (Albany, NY)
- …analytical and communication skills Preferred + Associate's Degree + 3 years with claims processing and data management + Past auditing and strong ... areas. Uses information to generate topics for education, training, process changes, risk reduction, optimization of reimbursement with new and current coders in… more