- Molina Healthcare (Buffalo, NY)
- …and distribute standard reports on schedule + Position reports to AVP, Payment Integrity Analytics **JOB QUALIFICATIONS** **REQUIRED EDUCATION** : + Bachelor's ... and/or Project management experience. + Managed Care experience - **_specifically within Payment Integrity , Claims Payment , Provider Relations Experience_**… more
- Molina Healthcare (Buffalo, NY)
- …work of external vendors. Assigns, directs and monitors system analysis and program staff. These positions' primary focus is project/ program management. **Job ... of external vendors. + Focuses on process improvement, organizational change management, program management and other processes relative to the business. + Leads and… more
- Molina Healthcare (Buffalo, NY)
- …This role focuses on identifying and executing operational initiatives tied to Payment Integrity (PI) and provider claims accuracy. The individual will ... lens to ensure accurate interpretation of provider claims trends, payment integrity issues, and process gaps. +...6 years of experience as a Business Analyst or Program Manager in a Managed Care Organization… more
- Molina Healthcare (Buffalo, NY)
- …workflows and controls across intake, adjudication, adjustments, appeals/grievances, and payment integrity . + Technology Enablement: Oversee requirements, ... (Healthcare/Claims)** + Deep understanding of claims lifecycle, EDI transactions, payment integrity , provider data, appeals/grievances, and audit/compliance… more
- Molina Healthcare (Buffalo, NY)
- …level of care, inpatient readmission, and any opportunity identified by the payment Integrity analytical team; makes decisions and recommendations pertinent to ... for medical claim review activities. Responsible for ensuring timely claims payment processes, providing counsel to members regarding coverage and benefit… more
- Molina Healthcare (Buffalo, NY)
- …Level of Care, Inpatient Readmission, and any opportunity identified by the Payment Integrity analytical team; requires decision making pertinent to clinical ... database + Provides supporting documentation for denial and modification of payment decisions + Independently re-evaluates medical claims and associated records by… more
- Indus Hospitality Group (Springville, NY)
- …Customer Care Award, and TripAdvisor Awards for Excellence. Reports To:Guest Service Manager or Assistant General Manager Summary Responsible for performing a ... Post charges (ie room, food, telephone), compute bill, collect payment , and make change for guests. + Make and...reservations. + Monitor room availability. + Block rooms. + Program wake-up calls. + Handle guest mail and messages.… more