Job Summary Analyze, review, and process suspended claims, predetermination, and Service Requests based on industry standards and clinical guidelines. Research, analyze, and investigate member benefits, policy and...
MetroPlusHealth provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care,...
Summary of Job Responsible for upholding the standard for code review functions in the setting of claims review, grievance and appeal, and new medical policy implementation. Identify inconsistencies between CCI & EH reimbursement policies and...
Empower. Unite. Care. MetroPlusHealth is committed to empowering New Yorkers by uniting communities through care. We believe that Health care is a right, not a privilege. If you have compassion and a collaborative...
Audit Supervisor - Global Corporate and Investment Banking- Hybrid REMOTE 3 days on site, 2 days remote New York, NY, US $100,000 - $140,000 / yr Job Description:This job is responsible...
Job Description Billing Coordinator - Central Administration - Staten Island - Full Time - Days - OFFSITE The Offsite Billing Coordinator is responsible for multiple components of the billing process,...
Title: Billing Compliance Specialist Location: Upper East Side Org Unit: Billing Support 2 Work Days: Monday-Friday Weekly Hours: 35.00 Exemption Status: Exempt Salary Range: $73,000.00 - $82,650.00...
Description Position at MTA Headquarters JOB TITLE: Senior Owner - Insurance Programs Administration Claims SALARY RANGE: $85,000 - $90,000 HAY POINTS: 496 DEPT/DIV: Risk Management...
Claim Account Manager - Group Captives New York, NY/Hybrid | United States of America Our Claims team sets us apart. Our experienced Claims professionals use their specialized expertise to handle even the most complex claims...
The Payment Integrity (PI) Analyst will assist in the development of a strategic roadmap to recover, eliminate, and prevent unnecessary medical-expense spending and support the execution for a comprehensive claim accuracy program. The incumbent will...