- Lincoln Financial Group (Albany, NY)
- …**Requisition #:** 74121 **The Role at a Glance** We are excited to bring on a Claims Customer Care Associate to join our claimant excellence team supporting ... Group Protection in a remote environment. Background Details The Claimant Excellence Team will...development to perform in this fast-paced environment. As a Claims Customer Care Associate , you… more
- Humana (Albany, NY)
- …and judgement to make determinations whether requested services, requested level of care , and/or requested site of service should be authorized at the Inpatient ... communication of decisions to internal associates, and possible participation in care management. The clinical scenarios predominantly arise from inpatient or… more
- Takeda Pharmaceuticals (Albany, NY)
- …in order to bring life-changing therapies to patients worldwide. Join Takeda as Associate Director, Global Labeling Lead where you will be responsible for the ... labeling requirements to be provided to patients and Health Care Providers while minimizing the risk of write-offs. +...to ensure consistency with the overall product strategy, product claims and information in the CCDS and to ensure… more
- Trinity Health (Albany, NY)
- …resolves claim edits that occur after coding to support timely final claims submission. Assigns appropriate code(s) by utilizing coding guidelines established by: + ... Patient Business Services (PBS) teams, when needed, to help resolve billing, claims , denial and appeals issues affecting reimbursement. Maintains CEUs as appropriate… more
- Merck (Albany, NY)
- **Job Description** The Associate Director Data Science will be responsible for developing and communicating data-driven and actionable insights that drive greater ... analyze data leveraging advanced analytical/statistical techniques from disparate databases/sources ( claims data/EMR Data and other sources) to drive optimization… more
- Humana (Albany, NY)
- …looking for an experienced medical coding auditor to review inpatient hospital claims for proper reimbursement, handle provider disputes in a result-oriented and ... payments in our payer systems, and by ensuring correct claims payment and appropriate diagnosis related group (DRG) assignments....**What Humana Offers** We are fortunate to offer a remote opportunity for this job. Our Fortune 100 Company… more
- Humana (Albany, NY)
- …first** Humana's Clinical Analytics Team is seeking a Lead Research Scientist ( Remote ). Healthcare is rapidly changing, and our members are living longer, often ... clinical concepts and extract clinical information from medical, pharmacy, and lab claims for analytics and modeling purposes + Translates analytic results into key… more
- Humana (Albany, NY)
- …service activities through data integrity management and gathering of provider claims data needed for service operations. The Network Operations Coordinator 3 ... with CRM + Experience with DCAV process + Previous experience in claims + Prior contract interpretation experience **Additional Information** This position is… more
- Intermountain Health (Albany, NY)
- …and reconsideration needs. Promotes the quality and cost effectiveness of patient care using clinical acumen in preparation of documentation, audits of patient ... + Collaborate with various caregivers within or outside department, provider networks and clinical care site partners and care team to coordinate patient care… more
- Humana (Albany, NY)
- …first** The Corporate Medical Director relies on medical background and reviews health claims . The Corporate Medical Director works on problems of diverse scope and ... of established clinical experience + Knowledge of the managed care industry including Medicare, Medicaid and or Commercial products...protect member PHI / HIPAA information This is a remote position \#LI- Remote **Scheduled Weekly Hours** 40… more
- Humana (Albany, NY)
- …working with health insurance operations related data to include enrollment, claims , billing and Reconciliation and/or contact center (Call center) data **Additional ... Information** **Work Style** : Remote **HireVue Statement** : As part of our hiring...(collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and… more