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Will work with Provider Contracting, Credentialing, Claims Operations, Utilization Management, and Network Management to setup systems to ensure accuracy of payments processing. Oversee functions performed by delegated vendor(s) as it relates to benefit configuration, claims processing, provider setup and account payable system.
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In this role you’llOversee the execution of intricate projects within CLX, ensuring alignment with business goals and timely project completionBuild and maintain strong relationships with key stakeholders, including executive leaders and Product partners, to drive strategic initiatives for operational excellenceSupport comprehensive financial analysis and forecasting activities, contributing to the financial strategy of claims experience operations.
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Our team of specialist brokers, consultants and in-house claims management combine threat assessment, impact analysis and crisis management and response with individually structured insurance programs.
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This position reports to the AVP, SIU & Compliance who is located in New York, NY. As an SIU Investigator, you will be tasked with the identification, investigation, and deterrence of instances of fraud in both claims and underwriting for a multi-line, commercial carrier.
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Lead the new product development and execution process from ideation to launch including (but not limited to) developing concept/claims/storytelling, creative and pack design brief based on consumer insights and financial business case recommending cost of good and pricing targets to ultimately deliver new launches to market on time & within budget.
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We are seeking a Senior Civil Engineer with broad expertise in land development and/or site/civil/heavy construction project management to perform investigations and analyses, prepare reports, and provide expert testimony where technical knowledge, skill, experience, training and/or education are needed to help resolve civil litigation and insurance claims.
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LanceSoft is seeking a travel Sterile Processing Technician for a travel job in Rochester, New York. Job Description & Requirements Specialty: Sterile Processing Technician Discipline: Allied Health Professional Start Date: 10/03/2024 Duration: 13 weeks 40 hours per week Shift: 8 hours, nights Employment Type: Travel Job Requirements BLS (American Heart Association ONLY) Three (3) years experience HSPA cert or a CBSPD cert Skill in cleaning specialized equipment.
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The Accounts Payable Supervisor will manage their assigned Accounts Payable team members and direct the processing and timely payment of invoices and credits, and reliable, easily accessible recordkeeping, liaising with vendors and Fresh Direct business partners.
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Pay Information $15 to $20 per hour About The Position Specialty : Sterile Processing Technician Job Description: Performs and participates in decontamination, cleaning, assembling, packaging, scanning, sterilization, storage and distribution of reusable surgical instrumentation and equipment.
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Combining both traditional and novel analytical approaches with diverse real-world data, including genomic, medical record, claims and patient-reported information, has allowed us to inform Life Science company internal decision making as well as submissions and presentations to regulators; health technology assessment authorities and payers; the medical community; and, patient organizations.
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Develop and optimize big data pipelines using Apache Spark ( Pyspark ) to handle large-scale data processing and analysis. Proven experience with Databricks, Delta Lake, and Apache Spark. The ideal candidate will possess extensive experience in creating, managing and optimizing data engineering pipelines using Databricks and associated technologies.
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Maintains the data entry, record-keeping and billing systems as mandated by funding sources (e.g.: Claims Conference, German Government Home Care grants, etc. Follows-up with Selfhelp’s Finance Department regarding processing of check requisitions, and other administrative details.
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Experience with at least one major Massively Parallel Processing (MPP) or cloud database technology (Snowflake, Redshift, Big Query) Hands-on production environment experience with distributed processing systems such as Spark.
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With 98% of cyber insurance claims in the past five years coming from small and mid-size businesses with revenue under $2B, providing an integrated solution to help manage risk is more critical than ever.
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Prior experience with Radiology Information Systems, PACS, Data processing and digital data transfer process. Registered X-Ray Technologist by American Registry of Radiologic Technologists (ARRT.
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claims processing jobs Company: Metroplus Health Plan in Bronx, NY
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