- WelbeHealth (Albany, NY)
- ** Claims Audit Analyst ** At WelbeHealth, we are transforming the reality of senior care by providing an all-inclusive healthcare option (PACE) to the most ... Services team helps ensure excellent care delivery for our participants, and the Claims Audit Analyst plays a pivotal role in ensuring timely and accurate… more
- Molina Healthcare (Yonkers, NY)
- …and the Affordable Care Act (ACA). + Medical Coding certification. + Strong Medical Claims Audit knowledge To all current Molina employees: If you are interested ... to support systems solutions development and maintenance for Medical Claim Audit . This role includes coordination with stakeholders and subject matter experts… more
- Warner Music Group (New York, NY)
- …label for the audit concerned; + Assist with the review and analysis of audit claims submitted by the auditor in question, as well as the relevant provisions ... the creative spirit of a nimble independent. **Job Title: Analyst , Audit ** Based on prior experience, the...the audit process, including, without limitation, tracking audit notifications, reviewing and analyzing the claims … more
- New York State Civil Service (Albany, NY)
- …DASNY - Dormitory Authority of the State of New York Title Senior Construction Claims Analyst (Cost Control) - Albany, NY or NYC Office Occupational Category ... State NY Zip Code 12208 Duties Description Primary PurposeSenior Cost Control Analyst reviews and recommends approval of construction change orders, analyzes … more
- Molina Healthcare (Buffalo, NY)
- …Responsible for accurate and timely auditing of critical information on claims databases. Maintains critical auditing and outcome information. Synchronizes data ... among operational and claims systems and application of business rules as they...and in accordance with unit standards. **Knowledge/Skills/Abilities** * Trains audit staff on configuration functionality, enhancements and updates. *… more
- Jacobs (Buffalo, NY)
- …the Contract, determine validity * Day-to-day tracking, review, and management of delay claims assigned to the successful candidate * Audit contractor's claim ... is where you belong. This candidate will work in the claims department, analyzing delay claims brought against the State within a geographic region. The… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …and claims processing platform. . Manages case volumes and review/ audit schedules, prioritizing case load as assigned by Management. . Consistently demonstrates ... Description: Summary: The Payment Integrity DRG Coding & Clinical Validation Analyst position has an extensive background in acute facility-based clinical… more
- Molina Healthcare (Syracuse, NY)
- …Description** **Job Summary** Provides lead level support as a highly capable business analyst who serves as a key strategic partner in driving health plan financial ... and executing operational initiatives tied to Payment Integrity (PI) and provider claims accuracy. The individual will be relied upon to make independent, informed… more
- WMCHealth (Valhalla, NY)
- Compliance Analyst , 340B Program ( On-Site ) Company: WMC Advanced Physician Services PC City/State: Valhalla, NY Category: Executive/Management Department: Pharmacy ... Internal Applicant link Job Details: Job Summary: The 340B Program Compliance Analyst is responsible for maintaining regulatory compliance within the 340B Program… more
- MVP Health Care (Rochester, NY)
- …improvement. To achieve this, we're looking for an Overpayment Recovery and Monitoring Analyst to join #TeamMVP. If you have a passion for managing audits, medical ... customers in every interaction **Your key responsibilities:** + Manage recurring audit inventories, ensuring timely progression and completion of existing audits. +… more
- CUNY (Staten Island, NY)
- Business Data and Reporting Analyst , Level 2 (Provisional) - Human Resources **GENERAL DUTIES** Under supervision, provides and/or oversees expert end-user support ... systems planning, and/or technological troubleshooting while a Business Data and Reporting Analyst is a highly skilled end-user of CUNYfirst. There are 4 levels… more
- Genesis Healthcare (Roosevelt, NY)
- …and possible career growth opportunities. POSITION SUMMARY: The Licensed Behavior Analyst will provide services designed to facilitate improved behavior and skill ... a related field. 2. Must hold and maintain BCBA certification from the Behavior Analyst Certification Board (BACB). 3. Must hold a Licensed Behavior Analyst … more
- Independent Health (Buffalo, NY)
- …and external solutions supporting Reliance Rx initiatives. The Data Validation Analyst develops standard operating procedures (SOPs) for existing and new reports, ... completeness, accuracy, and adherence to business requirements. The Data Validation Analyst is responsible for performing quality verification tasks and ensuring the… more
- Warner Music Group (New York, NY)
- …insights from financial statements, perform reconciliations, update cash forecasts and budgets, investigate audit issues and claims , perform tasks as part of the ... creative spirit of a nimble independent. **Job Title: Sr. Analyst , Financial** **A little bit about our team:** Warner...excited to share this new opportunity for a Sr. Analyst , Participations with strong analytical & financial capabilities, to… more
- Molina Healthcare (Buffalo, NY)
- **Job Description** **Job Summary** The Analyst , Quality Analytics and Performance Improvement role will support Molina's Quality Analytics team. Designs and ... develops reporting solutions to assist HEDIS audit , rate tracking, and Identifying targeted Interventions and tracking...and reporting related to Managed care data like Medical Claims , Pharmacy, Lab and HEDIS rates. + Assist Quality… more
- Catholic Health Services (Rockville Centre, NY)
- …OASAS/OMH monthly claims and support County audits. + Medicaid DSH Audit preparation. + Prepare Budget Capital Survey. + Provide subject matter expertise and ... Health was named Long Island's Top Workplace! Job Details The Senior Financial Analyst reports to the Reimbursement team within the Corporate Finance department, and… more
- City of New York (New York, NY)
- Job Description APPLICANTS MUST BE PERMANENT IN THE ADMINISTATIVE STAFF ANALYST CIVIL SERVICE TITLE OR BE PERMANENT IN A COMPARABLE TITLE ELIGIBLE FOR 6.1.9 TITLE ... (DHS). DSS-AO maintains the operation of the Office of Audit and Quality Assurance (OAQA), Office of Compliance &...Office of Revenue is recruiting for (1) Admin Staff Analyst NM III to function as a(n) Executive Director,… more
- NYU Rory Meyers College of Nursing (New York, NY)
- Position Summary Manage claims adjudication by identifying contractual variances between posted and expected reimbursement for Article 28, Managed Care, Commercial ... Insurance and other payers. Analyze, audit and recover outstanding receivables. Identify trends in payments,...Contact payer to resolve appeals and final solution to claims . Collaborate with the Director of Insurance Strategy in… more
- Insight Global (Mount Pleasant, NY)
- …in developing and maintaining automated data quality checks, reconciliation processes, and audit trails for all critical marketing data sources (eg, Veeva, Claims ... Skills and Requirements -10+ years' experience as a Commercial IT Principal Data Analyst -5+ years of recent SQL experience writing SQL queries for data extraction… more
- Molina Healthcare (Rochester, NY)
- …care or payer environment. + In-depth knowledge of medical and hospital claims processing, including CPT/HCPCS, ICD, and modifier usage. + Strong understanding of ... claim system configurations, payment policies, and audit processes. + Exceptional analytical, problem-solving, and documentation skills. + Ability to translate… more