- Brighton Health Plan Solutions, LLC (New York, NY)
- About The Role Brighton Health Plan Solutions (BHPS) is seeking an experienced Claim Dispute Specialist skilled in investigating and resolving provider ... Essential Qualifications + Strong knowledge of contracts, medical terminology, and claim dispute processing and procedures. + Previous experience handling… more
- Axis (New York, NY)
- …+ Experience presenting to senior management and outside partners + Knowledge of claims and litigation management, dispute resolution processes, and trials and ... selection process. **Job Description** AXIS is seeking a **_Claims Specialist - Management Liability_** to join our North America... - Management Liability_** to join our North America Claims team. The selected candidate will work closely with… more
- Molina Healthcare (Buffalo, NY)
- …and prepares written response to incoming provider reconsideration request is relating to claims payment and requests for claim adjustments or to requests from ... + Responsible for the comprehensive research and resolution of the appeals, dispute , grievances, and/or complaints from Molina members, providers and related outside… more
- Independent Health (Buffalo, NY)
- …fosters growth, innovation and collaboration. **Overview** The Clinical & Coding Specialist -Senior will be responsible for reviewing coding and clinical decisions on ... share knowledge and audit tips across the team. The Clinical & Coding Specialist -Senior will support the leadership in Hospital Audit in accomplishing all aspects of… more
- Entergy (Buchanan, NY)
- …contract governance and provide oversight of supplier performance management, including claims management and dispute management/resolution + Establish and ... with a focus on rotating and reciprocating generation and/or renewables. The specialist will support the identification, development, and execution of projects by… more