- Molina Healthcare (Albany, NY)
- …of knowledge although they may have technical team members. **Expanded Scope:** The Senior Project Manager for Claims Operations drives complex, ... & Regulatory Acumen (Healthcare/ Claims )** + Deep understanding of claims lifecycle, EDI transactions, payment integrity, provider data, appeals/grievances,… more
- CVS Health (Albany, NY)
- …strategic initiatives, and partnering to elevate insights that can positively impact provider experience. The Senior Manager , accounts receivable ... to help review, understand, and identify process improvements across key provider journeys including self-service / digital transactions, claims management,… more
- Zurich NA (Albany, NY)
- …**This role will be filled at either the** ** Senior or AVP Claims Professional** **Level.** **The hiring manager will determine the appropriate level based ... + Microsoft Office experience + Knowledge of insurance regulations, markets, and products OR Senior Claims Professional: + Bachelor's Degree and 6 or more years… more
- New York State Civil Service (Albany, NY)
- …HELP No Agency DASNY - Dormitory Authority of the State of New York Title Senior Construction Claims Analyst (Cost Control) - Albany, NY or NYC Office ... Control Analyst reviews and recommends approval of construction change orders, analyzes claims , and participates in the negotiation of claim settlements on complex… more
- CVS Health (Albany, NY)
- …to solution design and architecture discussions, collaborating with architects and senior engineers. + Provide input on technical feasibility, performance ... project work that crosses many Aetna Technology domains/applications. A Release Manager in this area requires substantial business and systems knowledge along… more
- Humana (Albany, NY)
- …The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business Intelligence Engineer will be an integral part of the Pricer Business ... the Integrated Network Payment Solutions (INPS) department which falls under the Provider Process and Network Organization (PPNO). The Senior Business… more
- GE Vernova (Schenectady, NY)
- …potential contract scope deviations with IPM/Functions; escalate to Project Director/Project Manager claims requiring customer negotiation. + Coordinates the ... on monthly basis to identify the critical impacts and provide the mitigations suggestions. + Organize monthly 'schedule deep...deep dives' providing guidance & insights to project and senior management + Ensure project schedule updates and KPIs… more
- Molina Healthcare (Albany, NY)
- …and rejection inventory, and works with other areas including IT, health plan, claims , provider , enrollment, regulators, and external vendors, as needed, to ... departments for error resolution, follow up, and performance monitoring. + Understands provider , member, and, inbound claims data compliance in relation to… more
- Cardinal Health (Albany, NY)
- …billing questions and set up payment arrangements if needed. + Analyze claims , process payments and complete adjustments + Analyze explanation of benefits (EOBs) ... Flag trends or recurring issues for team Supervisor or Manager . + Meet daily/weekly productivity goals (eg, number of.... + Meet daily/weekly productivity goals (eg, number of claims worked, follow-ups completed). + Assist with special projects,… more
- Fujifilm (Albany, NY)
- **Position Overview** The Regulatory Compliance Manager (Corporate) is a member of the FUJIFILM Holdings America Corporation ("HLUS") Department reporting to the ... Corporate Compliance Director. The Compliance Manager will be responsible for managing the day-to-day operations...you're shaping tomorrow's tech or redefining today's processes, we'll provide a flexible work environment and dynamic culture where… more
- Cardinal Health (Albany, NY)
- **Job Summary:** The Manager , Revenue Cycle Management, is responsible for overseeing the insurance collection follow-up team to ensure timely and accurate ... resolution of outstanding insurance claims . This role leads strategy development, performance monitoring, and process improvement initiatives to optimize cash flow,… more
- CenterWell (Albany, NY)
- …CenterWell creates experiences that put patients at the center. As the nation's largest provider of senior -focused primary care, one of the largest providers of ... Medical Director, Primary Care relies on medical background and reviews health claims . The Medical Director, Primary Care work assignments involve moderately complex… more
- Walgreens (Saratoga Springs, NY)
- …certification/registration. Otherwise, earns PTCB certification as condition of promotion to senior technician. + Attends training requested by Manager and ... of Conduct. + Performs duties as assigned by Pharmacy Manager , Staff Pharmacist and Store Manager including...those to physicians. + Processes (corrects and resubmits) manual claims for third party program prescription services in a… more
- Walgreens (Amsterdam, NY)
- …Co. Pharmacy Code of Conduct. + Performs duties as assigned by Pharmacy Manager , Staff Pharmacist and Store Manager including utilizing pharmacy systems to ... pharmacist, including those to physicians. + Processes (corrects and resubmits) manual claims for third party program prescription services in a timely and efficient… more
- New York State Civil Service (Albany, NY)
- …provides legal services and support to the Board of Trustees, the Chancellor and senior officers for the State University of New York (SUNY) at SUNY System ... and administrators of the campuses within the System. Under the leadership of the Senior Vice Chancellor for Legal Affairs and the General Counsel, the SUNY Office… more
- Public Consulting Group (Albany, NY)
- …more, visit www.publicconsultinggroup.com . Summary: We are seeking a senior -level, detail-oriented and self-motivated Medicaid Waiver Evaluation Consultant to join ... understanding of Medicaid waivers. **Duties and Responsibilities** + Serves as project manager and subject matter expert within the practice including management of… more