- Healthfirst (NY)
- …disputes/appeals and provides guidance across all areas of the company with regards to claims editing and proper coding , billing, and payment. + Researches and ... **Duties & Responsibilities** : + Conducts routine assessments of current claims edits and ensures comprehensive and defensible editing across all Healthfirst… more
- Healthfirst (NY)
- …a simple and easy to understand manner to other staff. As the SME, the Claims Configuration Analyst will need to effectively communicate with all levels of the ... + Assist in the on-going evaluation of configuration for new and existing claims business rules including member benefits, claims editing, reference data and… more
- Healthfirst (NY)
- …the development and configuration of new business, member benefits and products, claims editing, reference data and their enhancements including claims ... enhancements. + Follow the annual product development processes to manage major claims configuration projects, including claims business rule set up outlier… more
- SUNY Upstate Medical University (Syracuse, NY)
- …coding guidelines + Conducts internal reviews to improve revenue cycle, claims production and coding integrity + Demonstrated continuing self-development ... Position Overview: The UCM Revenue Integrity and Compliance Analyst will be a dynamic and self-motivated individual able to provide revenue cycle support to the… more
- Trinity Health (Niskayuna, NY)
- **Employment Type:** Full time **Shift:** Day Shift **Description:** **Medical Billing Analyst - Cardiology Associates of Schenectady - Niskayuna, NY - Full Time** ... If you are looking for a Billing Analyst position in Albany, Full time, this could be...Medical Associates. **Responsibilities:** + Responsible to monitor and resolve Claims Workqueues; Specifically, Front End, Referrals & Authorizations, and… more
- University of Rochester (NY)
- …not limited to: rules associated with Epic work queues, edits, errors, charging, claims logic, coding , cash posting, billing rules, payer rules/regulations, and ... and internal equity considerations._ **Responsibilities:** GENERAL PURPOSE: The Technical Analyst is responsible for working across the professional fee billing… more
- VNS Health (Manhattan, NY)
- …Plans pays our Providers appropriately and contains cost. + Investigates utilization and claims coding patterns to identify potential fraud, waste or abuse and ... analytics preferred + Knowledge of Medicare and NYS Medicaid claims processing rules and coding experience with DRG, ICD10 and CPT4 required + Proficiency… more
- Weill Cornell Medical College (New York, NY)
- …a number of projects. Ideal candidate will have experience analyzing health insurance claims data, preferably Medicare data specifically, and coding expertise in ... Title: Programmer Analyst II Location: Upper East Side Org Unit:...Coding expertise in SAS Experience analyzing health insurance claims data, preferably Medicare data specifically **Knowledge, Skills and… more
- Molina Healthcare (NY)
- **JOB DESCRIPTION** **Job Summary** The Senior Analyst , Medical Economics provides support and consultation to the Health Plan and Finance team through analyzing key ... decision-making + Mine and manage information from large data sources. + Analyze claims and other data sources (eg authorization) to identify early signs of trends… more
- Elevance Health (Latham, NY)
- **Provider Contract/CofC Analyst Sr.** **Location:** This position will work a hybrid model (remote and in-office, 1 - 2 days per week). Candidates must live within ... miles of one of Elevance's Pulse Point locations. The **Provider Contract/Cost of Care Analyst Sr.** is responsible for analytical support to the Cost of Care and/or… more
- Healthfirst (NY)
- **Duties and Responsibilities:** + Handle premiums, claims , enrollment, and administrative expense data for reports to government and regulatory entities (such as ... Qualifications:** + Passed 1 to 2 Actuarial Exams + Experience with programming/ coding , preferably SAS, SQL, or Python + Experiencing working with large and… more
- Elevance Health (East Syracuse, NY)
- …appeals by external accreditation and regulatory requirements, internal policies, and claims events requiring adaptation of written response in clear, understandable ... and analyze the grievance and appeal issue(s) and pertinent claims and medical records to either approve or summarize...and regulatory standards and requirements. + As such, the analyst will strictly follow department guidelines and tools to… more
- Deloitte (New York, NY)
- …on 9/3/24. Work you'll do As a Technology Senior Consultant (Business Analyst /Configuration Lead) within our practice, your responsibilities will include: + Leading ... governance structure and process design, contractual compliance, risk management, claims management, and project controls and analytics Qualifications required: +… more