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7-10 years of claims operations experience in the managed care industry with a minimum of 3 years in a leadership role. As a wholly owned subsidiary of NYC Health + Hospitals, the largest public health system in the United States, MetroPlusHealth network includes over 27,000 primary care providers, specialists and participating clinics.
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NYC Health + Hospitals is the largest public health care system in the United States. At NYC Health + Hospitals, our mission is to deliver high quality care health services, without exception.
$70,000 - $100,000 a yearFull-timeExpandApply NowActive JobUpdated Yesterday - UpvoteDownvoteShare Job
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Registered Nurse (RN), with at least at least 3 years of audit experience in an acute care hospital environment and appropriate certifications, such as an AHIMA issued Certified Coding Specialist (CCS.) Experience in any of the following: claims auditing/quality assurance/recovery auditing – ideally in a DRG / Clinical Validation Audit setting or hospital environment strongly preferred.
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VOC Admin (Legal cases (Attorney General (AG)/Small Claims. Speak with legal defense on small claims. Few years of experience handling customer service claims. Claim root cause analysis and register in GCIC and REVO system.
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WHCC is deemed by the Bureau of Primary Health Care of the U.S. Department of Health and Human Services to be a federal employee for purposes of medical malpractice claims and, as such, qualified for protection under the Federal Tort Claims Act.
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Through the integration of its hospitals, labs, and schools, Mount Sinai offers comprehensive health care solutions from birth through geriatrics, leveraging innovative approaches such as artificial intelligence and informatics while keeping patients' medical and emotional needs at the center of all treatment.
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CNS provides unparalleled home health care to the American Workforce including Veterans of the United States Armed Services, Workers Compensation Claims, and former energy workers who want to remain independent and live in their own homes.
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Support the maintenance of provider networks to include pharmacy, diagnostic testing, durable medical equipment (DME), transportation, and on-going care as appropriate. Responsible for end-to-end Case Management and oversight for the client site, communication and coordination across all relevant activities associated with workers compensation and/or personal disability claims.
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Manage and lead the revenue cycle management team and processes, including benefits verification, claims submission, payment posting, denials management, and revenue optimization. You will be responsible for managing and optimizing the end-to-end revenue cycle operations, including benefits verification, claims submission, payment posting, denials management, and revenue optimization.
$100,000 - $120,000 a yearFull-timeExpandApply NowActive JobUpdated 5 days ago - UpvoteDownvoteShare Job
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Knowledge of specialty prescription drug names, NDC drug codes, therapeutic classes and claims processing preferred. Engagement Description – PA Specialist in Pt B Pharmacy will support client providers (physicians and other healthcare providers rendering medical care) with Medicare Part B drug coverage inquiries, and prior authorizations.
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EQ offers a comprehensive product set, including transfer agency services, cap table management, equity compensation services, proxy solicitation and advisory services, private company solutions and bankruptcy claims administration services.
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Plan, coordinate, and drive execution and implementation with and on behalf of the Group Insurance Claims and Service senior leaders, this includes influencing leaders and stakeholders to deliver outcomes.
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Comprehension of healthcare data (e.g., ICD-10, claims) and demonstrated understanding of health care and delivery system processes. Extract and analyze large healthcare claims using SAS, SQL, R, Python, Teradata, Hadoop, etc.
$109,100 - $181,800 a yearFull-timeRemoteExpandApply NowActive JobUpdated 8 days ago - UpvoteDownvoteShare Job
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Assist in coordination of clinical operations, including medical surveillance, OSHA recordkeeping, facility operations and patient care activities such as episodic or emergency visits, first aid, and other activities as needed.
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Manages Leave of Absence Administration for employees within the lines of business as well partners with Risk Management on Workers Compensation claims and accidents. DocGo is leading the proactive healthcare revolution with an innovative care delivery platform that includes mobile health services, population health, remote patient monitoring, and ambulance services.
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care claims jobs in New York, NY
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