- Molina Healthcare (Albany, 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
- 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 (Albany, 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
- MVP Health Care (Schenectady, 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
- Molina Healthcare (Albany, 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
- Molina Healthcare (Albany, 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
- Hamilton-Fulton-Montgomery BOCES (Johnstown, NY)
- …the oversight of payroll accounting and various reports; Responsible for the annual audit of all accounts maintained or supervised by the Treasurer, BOCES; Conducts ... certified payroll or Board resolution; Oversees the preparation of Warrant of Claims for all accounts including generation of warrants, entering of purchase order… more
- Highmark Health (Albany, NY)
- …with a general understanding of data flows from various corporate systems (eg, claims , billing, lab, and Rx), to solve complex issues and problems. A comprehensive ... include but not limited to, review/editing of content submissions and best practices, audit reports, etc. The incumbent is expected to make major contributions to… more