- Molina Healthcare (Buffalo, NY)
- …functionality through project inclusion and documentation review to understand proper claims processing for the applicable solution. Validates data received ... support issues related to EDI transaction editing and custom claims processes to determine root cause of issue. Gains...claims to identify billing issues that will impact claims processing and payment. Monitor new solutions implemented to… more
- Amazon (New York, NY)
- …The Program, Project, Product, and Vendor Management Team within Amazon's Logistics Claims Management and Operations group is seeking a motivated and experienced ... Senior Risk Manager. The ideal candidate will be familiar with insurance and claims programs, and insurance policies, have a history of success in procurement,… more
- Capital One (New York, NY)
- Sr . Distinguished Engineer - Fraud Technology (Remote-Eligible) As a Sr . Distinguished Engineer at Capital One, you will be a part of a community of technical ... on our customers' lives. We are looking for a Senior Distinguished Engineer to define, architect and drive the...Define and drive technical strategy and roadmap for our systems and platforms that power Fraud defenses and Fraud… more
- Molina Healthcare (New York, NY)
- …Maintains critical provider information on all claims and provider databases. Synchronizes data among multiple claims systems and application of business ... rules as they apply to each database. Validate data to be housed on provider databases and ensure...and best practices while suggesting improvement processes to ensure systems are working more efficiently and improve quality. +… more
- Two95 International Inc. (New York, NY)
- …SOW will meet their needs * Lead the discovery of the client's EMR/EHR and/or claims data environment so we can efficiently and effectively navigate and do the ... Job Title: Sr . Analytics Consultant Job type : Remote Work...analyses * Lead the analytical-interrogation of their EMR/EHR and/or claims data to perform data … more
- Warner Music Group (New York, NY)
- …company that retains the creative spirit of a** **nimble independent.** **Job Title: Sr . Analyst, Financial** **A little bit about our team:** Warner Music Group's ... development opportunities. We're excited to share this new opportunity for a Sr . Analyst, Participations with strong analytical & financial capabilities, to join our… more
- Acxiom (New York, NY)
- …and segment longitudinal healthcare provider and HIPAA compliant patient's health claims data to optimize targeted engagement strategies. **Audience Portfolio ... Epidemiology, Life Sciences or Public Health. 4+ years advanced analytics and data experience in healthcare systems , health-tech or pharmaceutical industry,… more
- Ducommun (Coxsackie, NY)
- Sr . Human Resources Generalist Provides full range of support in all areas of HR including recruiting, benefits administration, employee relations, training, ... development, orientation, data administration and documentation, talent management, HR compliance, and all related activities. Internal Communication and… more
- Evolent (Albany, NY)
- …Familiarity with value-based care and utilization management is preferred + Understanding of data systems and the critical thinking skills to solve new problems ... interactions fostering expertise and cooperation. + Extract, manage, and analyze claims and operational data using industry-standard metrics. **Qualifications… more
- Molina Healthcare (New York, NY)
- … claims databases. Maintains critical information on claims databases. Synchronizes data among operational and claims systems and application of ... business rules as they apply to each database. Validate data to be housed on databases and ensure adherence...information into the claim payment system and other applicable systems . + Participates in defect resolution for assigned component… more
- University of Rochester (Rochester, NY)
- …determined by considering factors including, but not limited to, market data , education, experience, qualifications, expertise of the individual, and internal equity ... the goals and expectations established for the Office of Counsel, the Senior Counsel identifies, analyzes and provides legal guidance and services on complex… more
- University of Rochester (Rochester, NY)
- …business intelligence to inform plan decisions. + Maintains several relational data systems and business decision models based on claims and utilization ... determined by considering factors including, but not limited to, market data , education, experience, qualifications, expertise of the individual, and internal equity… more
- Elevance Health (Latham, NY)
- **Business Consultant Senior - Commercial Claims Data Mining** **Hybrid 1:** This role requires associates to be in-office 1-2 days per week, fostering ... and adaptable workplace. Alternate locations may be considered. The **BUSINESS CONSULTANT SENIOR ** is responsible for translating the most highly complex and varied… more
- Intermountain Health (Albany, NY)
- …of actual and budgeted contractual allowances and variances, monitoring of individual claims (logs), etc.). Interacts with HIM, PAS, and hospital finance staff as ... **Qualifications Required** + Demonstrated experience in a role requiring data analysis. + Demonstrates computer skills including spreadsheets, databases, word… more
- MetLife (New York, NY)
- …and possess in-depth knowledge of plan designs, benefit features and how claims are paid * Strong understanding of industry marketplace and legal developments. ... all levels of the organization * Ability to analyze data to influence and execute on renewal decisions *...computer navigation skills and ability to work in multiple systems simultaneously (Microsoft suite, different company platforms) * Strong… more
- Axis (New York, NY)
- …volume of tasks efficiently * Proactively asks questions to ensure proper handling of claims * Willingness to learn new systems and processes in a fast-paced ... for candidates taking part in the selection process. Reinsurance Senior Claim Specialist - Job Description Job Family Grouping:...Claim Specialist - Job Description Job Family Grouping: Reinsurance Claims Job Family: Claims Location: New York… more
- Axis (New York, NY)
- …+ Background in designing, developing, and implementing IT systems within claims operations. + Solid understanding of data analysis, budgeting, and business ... Claims Value Stream Lead will collaborate closely with Claims senior leadership to translate their needs...learn and share knowledge. + **Making Disciplined Decisions:** Use data and analytics to form plans and actions, exercising… more
- Axis (New York, NY)
- …specialty insurers + A good working knowledge of the workstreams, workflows, processes, and claims systems , in aP&C claims organization, for both North ... multiple departments. The Product Owner would focus on managing and enhancing claims -related products, systems , and processes. Their role involves translating… more
- City of New York (New York, NY)
- …to contracting with government and/or insurance companies. - Experience guiding insurance claims data analysis - Experience in Management Service Organizations, ... impacted NYC communities. CHECW addresses inequity across community and healthcare systems in partnership with community, faith-based, and health care organizations.… more
- BAE Systems (Endicott, NY)
- … senior level, experienced lawyer to serve in a key role within the BAE Systems legal team, acting as senior labor and employment counsel to our internal ... in its transactions and protect the company against potential claims and litigation. This role is required to be...to include:** + This person will function as a senior level labor and employment specialist supporting the Deputy… more