- Ankura (Lexington, NY)
- …is a team of excellence founded on innovation and growth. Ankura's Disputes & Economics professionals are world class and globally recognized independent experts ... who tailor financial, operational, and compliance solutions to complex litigation, enforcement, and regulatory challenges....Director will support the Healthcare Payer team within Ankura's Disputes & Economics practice - one of seven practices… more
- Ankura (Lexington, NY)
- …A recognized leader in healthcare litigation support, Ankura's Healthcare Disputes team combines unparalleled clinical, technical, and operational experience with ... analytical offerings for our clients that reveals how this information impacts legal disputes that these companies may be facing. We combine in-depth operational, … more
- Humana (Albany, NY)
- **Become a part of our caring community and help us put health first** Code Edit Disputes team reviews and educates providers when there is a dispute on ... millions of people we serve to achieve their best health - delivering the care and service...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
- Western Digital (Albany, NY)
- …in data. **Job Description** **Position Summary** We are looking for a **Retail Compliance Specialist** to join the Western Digital Fulfillment Operations Team to be ... strong communication skills. **Essential Duties and Responsibilities:** + Experience with retail compliance and penalty programs (eg, Walmart's OTIF - On Time In… more
- CVS Health (Albany, NY)
- …consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions ... At CVS Health , we're building a world of health...The Medicaid VBS Network State Manager manages and oversees compliance with our Network responsibilities as provided within the… more
- Humana (Albany, NY)
- …Humana processes, as well as a focus on collaborative business relationships, value based care , population health , or disease or care management. **Use your ... of service should be authorized at the Initial and Appeals/ Disputes level. All work occurs within a context of...millions of people we serve to achieve their best health - delivering the care and service… more
- Molina Healthcare (Albany, NY)
- …to review compliance -based issues for benefit planning purposes. **Recoveries & Disputes ** + Review and validate provider complaints and payment disputes , ... disputes , appeals, and overpayment recoveries in a managed care or payer environment. + In-depth knowledge of medical...years of experience in previous roles in a managed care organization, health insurance or directly adjacent… more
- Intermountain Health (Albany, NY)
- …claims and/or patient issues. Investigates and resolves claims submission, disputes or complaints to resolution, as needed. Resolves billing/insurance issues ... and ensures compliance with departmental and governmental policies. + Supports the...standards. + Promotes mission, vision, and values of Intermountain Health , and abides by service behavior standards. + Performs… more
- New York State Civil Service (Albany, NY)
- …Manage the carrier invoice dispute process, including opening and closing disputes based on validation of monthly-recurring invoices.* Process non-recurring invoices ... This involves validating against approved ITSM requests and ensuring contract rate compliance . ITSM Processing and Technical Support* Process and close ITSM requests… more
- YAI (Ulster County, NY)
- …to the community. + Responsible for the overall supervision, protection, and care of individuals at all times including maintenance of program guidelines for ... signs of an individual's potential harm to self or others. + Ensures health , wellness and safety by providing appropriate supervision of the people we support… more
- Amrize (Ravena, NY)
- …+ Health Savings Accounts (HSAs) & Flexible Spending Accounts (FSAs) for health and dependent care + Vision and other Voluntary benefits and discounts ... objectives and oversee quality control. **WHAT YOU'LL ACCOMPLISH** + Ensures Health , Safety and Environmental values, policies and standards are maintained and… more
- Sedgwick (Albany, NY)
- …Suite (Excel, Word, Outlook). + Ability to negotiate settlements and resolve claims disputes effectively. **TAKING CARE OF YOU** + Flexible work schedule. + ... and takes appropriate action. + Performs quality review on claims in compliance with audit requirements, service contract requirements, and quality standards. + Acts… more