to contracts, contract optimization, implementation of new programs and to assist with provider issues, education materials... and communicate contract terms, payment structures, and reimbursement rates to providers. Remain current on provider reimbursement...
supervision and direction, contract optimization, implementation of new programs and to assist with provider issues, education... materials, as well as contact for all escalated issues from the Provider and internal EmblemHealth departments, including...
. And we do it all with heart, each and every day. Position Summary Monitoring PR mailboxes which encompass provider claim... inquiries, credentialing follow up, ERA submissions, W9 requests, contracting inquiries, etc. Assign to Provider Engagement...
to ensure significant cost savings for provider contract holders using innovative continuous improvement methodologies..., will be responsible for collaborative work with the other members of the value-based reimbursement team, provider relations, senior...
Exciting Claims Specialist Opportunity! Location: Bronx, NY Schedule: 40 hours per week 2 days in-office, 3 days... to the next level? This Claims Specialist position offers the perfect balance of challenge, growth, and flexibility. Youll...
appropriate for the contract needs of provider agencies - Review performance indicators and other statistical data concerning...) is responsible for ensuring high-quality services are provided to children in foster care by supporting provider agency staff...
across all EmblemHealth lines of business. Serve as a subject matter expert in all areas of contract configuration, fee schedules/groupers.... Serve as the subject matter expert in NetworX. Responsibilities: Responsible for all aspects of provider, facility...
Software Guidance & Assistance, Inc., (SGA), is searching for a Production Support Specialist for a CONTRACT assignment... with Cloud technologies and supporting applications hosted on cloud SGA is a technology and resource solutions provider driven...
Implementation Specialist who is focused on providing great hospitality and appreciates the art of collaboration to join our team.... Develop project plans based on contract scope and schedules, and monitor the full project lifecycle from start to finish...
The Opportunity: You will be a customer-facing Vaccine Sales Specialist promoting main brands to Pediatrics... segments. Contact potential customers and negotiate product formulary acceptance Obtain contract commitments for CSL...
Validation Specialist to join our team and contribute to the development and training of our generative AI-powered clinical tools...: Previous experience working at a health plan, payment integrity firm, or healthcare provider, with a focus on DRG or coding DRG...
Claims Specialist, Bronx NY HYBRID: A minimum of 2 days onsite (usually Wednesday and Friday), though this may vary.... Schedule: Monday –Friday 8: 30 am-5: 30 pm (1 hour lunch) Contract Length: Long Term, potential for Direct Hire...
Software Guidance & Assistance, Inc., (SGA), is searching for a Human Resource Specialist for a CONTRACT assignment... working in the Financial Services industry SGA is a technology and resource solutions provider driven to stand out...
; processing of payments to provider agencies and vendors; monitoring the financial health of provider agencies through financial... Services (DFS), is responsible for ensuring all agency contract, subsidy and administrative payments are issued timely...
Software Guidance & Assistance, Inc., (SGA), is searching for an Internal Communications Specialist for a CONTRACT... solutions provider driven to stand out. We are a women-owned business. Our mission: to solve big IT problems...
Role: Express Services Specialist Location: 1290 Avenue of the Americas, New York, NY 10104 (Onsite) Position: 01... Months Contract Pay rate:- $18-20/hr. on W2 (non-benefited) Shift is M-F 9am to 5:30pm Client: Epiq Global JD: Top...
CLAIMS SPECIALIST Location: Wallerstein, Bronx NY Setting: A minimum of 2 days onsite (usually Wednesday and Friday...), though this may vary. Schedule: Monday –Friday 8: 30 am-5: 30 pm (1 hour lunch) Contract Length: Long Term/Ongoing...
contract value Qualifications and Experience Required 3+ years of industry, sales or market experience (prior experience... infrastructure and data provider. Our purpose is driving financial stability, empowering economies and enabling customers to create...
: review and evaluate appeal requests; identify and classify member and provider appeals. Using internal systems, determine... member and provider correspondence as needed for authorized representative or needed clinical information. Conduct thorough...
and provider relations Responsibilities: Comprehensively review and evaluate appeal and grievance requests to identify... and classify member and provider appeals. Determine eligibility, benefits, and prior activity related to the claims, payment...