- Staffing Solutions Organization (Albany, NY)
- …a reflection of our clients and the people they serve. **Senior Healthcare Program Specialist (Level 2 or 3) - Albany, NY** **Division of Eligibility & Marketplace ... the necessary determination regarding when and how to update eligibility and claims systems. + Take the appropriate actions regarding Medicaid enrollment and premium… more
- Kelly Services (Menands, NY)
- Claims Specialist Location: Menands, NY (Onsite) Company: Local non-profit organization Schedule: Mon-Fri, 9am-5pm Pay Rate: $24/hour to start A local nonprofit ... is seeking a skilled and detail-oriented Insurance and Claims Specialist to support a public health assistance program. This role is responsible for ensuring… more
- Allied Universal (Saratoga Springs, NY)
- **Company Overview:** Advance Your Career in Insurance Claims with Allied Universal(R) Compliance and Investigation Services. Allied Universal(R) Compliance and ... the position and eligibility. **Job Description:** Allied Universal(R) is hiring a Claims Investigator. Claim Investigators validate the facts of loss for Insurance … more
- Sedgwick (Albany, NY)
- …Fortune Best Workplaces in Financial Services & Insurance Disability Clinical Specialist **PRIMARY PURPOSE** : Performs standard clinical evaluations on claims ... and RESPONSIBILITIES** + Performs standard clinical reviews of referred medical claims based on client requirements to ensure accurate and sufficient information… more
- New York State Civil Service (Albany, NY)
- NY HELP Yes Agency Education Department, State Title Education Finance Specialist 1, Education Finance Specialist Trainee 1 (NY HELPS) (Multiple Positions), Box ... Department (NYSED) is seeking candidates for multiple Education Finance Specialist 1 positions in the Office of State Aid...projects;* Process revisions to school districts' prior year aid claims to ensure correct aid is paid and overpayments… more
- Molina Healthcare (Albany, NY)
- JOB DESCRIPTION Job Summary Provides support for claims activities including reviewing and resolving member and provider complaints, and communicating resolution to ... to ensure that internal and/or regulatory timelines are met. * Researches claims appeals and grievances using support systems to determine appropriate appeals and… more
- The Wesley Community (Saratoga Springs, NY)
- …20-22.52 per hour | Full Time Day | Robust and comprehensive benefits package! Billing Specialist for Skilled Nursing Facility Full Time | Days | 8am - 4:30pm We are ... seeking an experienced Billing Specialist professional who loves what they do! Everything we...types. + Monitor and maintain aging reports for outstanding claims . Respond to and resolve insurance claims … more
- Molina Healthcare (Albany, NY)
- …Responsible for reviewing and resolving Medicare member appeals and Medicare claims in communicating resolution to members and provider (or authorized ... to ensure that internal and/or regulatory timelines are met. + Research claims appeals using support systems to determine Medicare appeal and claim outcomes.… more
- Molina Healthcare (Albany, NY)
- …clear and concise to ensure accuracy in auditing of critical information on claims ensuring adherence to business and system requirements of customers as it pertains ... days of error issuance. * Evaluates the adjudication of claims using standard principles and state specific policies and...fraudulent billing practices, waste, overpayments, and processing errors of claims . ( _Use for claims specific positions… more
- MVP Health Care (Schenectady, NY)
- …thinking and continuous improvement. To achieve this, we're looking for a Data Entry Specialist to join #TeamMVP. If you have a passion for data entry and a ... Rochester, NY + 1-2 years of data entry or claims experience preferred. High accuracy and attention to detail....Word and Excel. + Familiarity with medical terminology and claims processing. + Curiosity to foster innovation and pave… more
- CDM Smith (Albany, NY)
- …40509BR **Business Unit:** FSU **Job Description:** The Disaster Program Delivery Specialist : * Collects, coordinates and/or reviews applicant data to determine ... expertise may be needed throughout the program delivery process. * Supports the claims process by reviewing and validating damage details, scopes of work, and costs… more
- New York State Civil Service (Albany, NY)
- …Agency Medicaid Inspector General, NYS Office of the Title Program Research Specialist 2 Occupational Category Other Professional Careers Salary Grade 23 Bargaining ... specific techniques are required. Advanced knowledge of SQL, Access, claims , external audits, and the DAR/FAR process are a...NY Zip Code 12204 Notes on Applying Free Parking. Please put: Program Research Specialist 2 in the subject… more
- Molina Healthcare (Albany, NY)
- …to ensure that internal and/or regulatory timelines are met. + Research claims appeals and grievances using support systems to determine appeal and grievance ... and accurately, in accordance with regulatory requirements. + Research claims processing guidelines, provider contracts, fee schedules and system configurations… more
- Walgreens (Ballston Lake, NY)
- …and maintaining front end and pharmacy asset protection techniques, and filing claims for warehouse and vendor overages (merchandise received, but not billed), ... for non-returnable ABC overstock. Verifies posting of all pharmacy/ prescription claims . + Completes execution of all pricing activities including price changes,… more
- Elevance Health (Latham, NY)
- **Account Specialist ** **Location:** **This role requires associates to be in-office** **1 - 2** **days** **per week, fostering collaboration and connectivity, while ... unless_ _an accommodation_ _is granted as required by law._ The **Account Specialist ** is responsible for supporting strategic sales and account associates in the… more
- Datavant (Albany, NY)
- …and life experiences to realize our bold vision for healthcare. The Specialist is responsible for identifying, analyzing, and resolving claim denials across the ... practices, and proficiency in multiple electronic systems and software tools. The specialist serves as a key liaison between coding, billing, utilization review,… more
- Trinity Health (Rensselaer, NY)
- **Employment Type:** Full time **Shift:** **Description:** **Quality Healthcare Specialist ** **Hybrid/remote options - local candidates needed due to onsite ... **benefits day 1 of employment** If you are looking for a **Quality Healthcare Specialist ** position in the Albany area, full time, this could be your opportunity.… more
- Molina Healthcare (Albany, NY)
- …and timely validation and maintenance of critical provider information on all claims and provider databases. Staff ensure adherence to business and system ... care experience + Experience in one or more of the following: Claims , Provider Services, Provider Network Operations, Hospital or Physician Billing, or similar.… more
- CDPHP (Latham, NY)
- …of that experience. With minimal direct management oversight, the Compliance Specialist researches, analyzes and processes all corporate regulatory complaints for ... to detail is key to this role. + Demonstrated knowledge of all claims processing systems, contracts, and riders. + Keen analytical skills, organizational, project… more
- MVP Health Care (Schenectady, NY)
- …and continuous improvement. To achieve this, we're looking for a **Chart Procurement Specialist ** to join #TeamMVP. This is the opportunity for you if you have ... education and complimentary experience preferred. + One year experience in a claims processing, health care/provide office setting or related position required. +… more
