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Department: MHP BUSINESS RESUMPTION PLNG. As a wholly-owned subsidiary of NYC Health + Hospitals, the largest public health system in the United States, MetroPlusHealth's network includes over 27,000 primary care providers, specialists and participating clinics.
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Certification/s: PHR/SPHR/CP/SCP preferredAt least three (3) years prior experience processing NYS workers’ compensation claims and/or FMLA leaves of absence, is preferred. Certification/s: PHR/SPHR/CP/SCP preferredAt least three (3) years prior experience processing NYS workers’ compensation claims and/or FMLA leaves of absence, is preferred.
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As a Large Loss Claims Experience Advocate, you’ll help us settle claims quickly and efficiently, surpassing customer expectations along the way. Through our Giveback program, we partner with organizations such as the ACLU, New Story, The Humane Society, Malala Fund, American Red Cross,.org, charity: water, and dozens of others, and have donated millions towards reforestation, education, animal rights, LGBTQ+ causes, access to water, and more.
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Three plus years of hands-on experience with Epic Resolute Billing in a real-time environment with Claims as they relate to the Resolute Module. Claims certification preferred. The Sr. Epic Resolute Revenue Cycle Analyst works with leadership to establish priorities for the Epic billing module, assisting systems analysts in implementing Epic Resolute updates and establishing Epic Resolute best practices and procedures.
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The Claims Adjuster are sent to client’s homes for pre-loss assessments & inventory, post-loss assessment & inventory, collections cataloging, reconstruction post loss including compiling inventory lists, photos, and in-depth client interviews.
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Working knowledge of health care EMR or claims systems (Epic/Clarity, eCW, Facets, QNXT, Amisys, etc.) Working knowledge of health care EMR or claims systems (Epic/Clarity, eCW, Facets, QNXT, Amisys, etc.
$86,000 - $165,000 a yearFull-timeExpandApply NowActive JobUpdated 5 days ago - UpvoteDownvoteShare Job
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Duties will include handling workers compensation and auto claims including bodily injury, physical damage, and property damage/liability claims. Serve as a technical resource concerning Workers' Compensation and auto claims; respond to inquiries and provide technical information concerning related laws, codes, rules, regulations, policies and procedures; respond to calls from employees, third-party administrator, physicians, medical facilities and others.
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Get exposure to civil law, including legal assistance (estate planning, family law, tax matters); tort claims (represent interests of the U.S. in tort issues such as Federal Tort Claims Act/Military Claims Act); labor law (arbitration and equal opportunity); and contract law (legal review of multi-billion dollar contracts of military technologies and supplies.
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Key stakeholder departments include, configuration, provider relations, provider credentialing, provider enrollment, claims, medical management and payment integrity. Takes the lead in identification and resolution of ongoing operational issues with providers, including but not limited to rate negotiation, reimbursement, billing/claims, configuration/system implementation, reporting/analytic needs, non-compliance.
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Technical evaluation of pharmaceutical industry data sources including claims, EHR, specialty pharmacy, sales, and customer master data. 5 years of hands-on experience using administrative claims (EMR/EHR, open and closed claims data sources) OTHER INFORMATION Eligible for employee bonus referral Candidate demonstrates a breadth of diverse leadership experiences and capabilities including: the ability to influence and collaborate with peers, develop and coach others, oversee and guide the work of other colleagues to achieve meaningful outcomes and create business impact.
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Medical claims, Medicaid and HEOR database search. Observational data, MarketScan, Optum, Market Clarity, EMC- Claims databases. Open to remote for experienced candidates with Medical Claims and EMR experience.
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Ethics & Compliance teams provide coordinated advice and assistance on independence, conflicts, regulatory and risk management issues, as well as dealing with claims, and any queries regarding the organization’s ethics.
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Reviews and analyzes Physician/Allied Health/GME applications for initial appointment and reappointment and credentialing documents including clinical education/training, board certification and eligibility, licensure, accreditation, work history, liability insurance and malpractice claims history.
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Work closely with relevant parties (CBP, Holders, Service Providers, Foreign National Guaranteeing Associations) to resolve claims efficiently and effectively. Provide expert guidance and support to internal staff, Customs officials, and other stakeholders on matters pertaining to ATA Carnets and claims resolution.
$85,000 - $115,000 a yearFull-timeExpandApply NowActive JobUpdated 6 days ago - UpvoteDownvoteShare Job
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The RoleSenior Claims Specialists at Willis Towers Watson drive proactive adoption of risk mitigation strategies and positive outcomes for clients who experience losses. Advocate for timely, optimal resolution of claims, including escalation/negotiation with claim service providers on disputed claims.
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claims mhp jobs Company: Metroplus Health Plan in New York, NY
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