Claims Quality Auditor is responsible for reviewing claims to determine if payments have been made correctly. This position analyzes data used in settling claims to determine the validity of payment of claims and reports overpayments, underpayments and other irregularities based upon benefit configuration, compliance with provider contract agreements, and Federal, State a

The world isn't standing still, and neither is Allstate. We're moving quickly, looking across our businesses and brands and taking bold steps to better serve customers' evolving needs. That's why now is an exciting time to join our team. You'll have opportunities to take risks, challenge the status quo and shape the future for the greater good. You'll do all this in an en

The challenges of affordable healthcare continue to create new opportunities. Elderplan and HomeFirst, our Medicare and Medicaid managed care health plans, are outstanding examples of how we are expanding services in response to our patients' and members' needs. These high quality healthcare plans are designed to help keep people independent and living life on their own t

Provides assistance to borrowers and venders as related to property preservation Drafts memorandums, letters, and other necessary documents as needed Prepares, reviews, and acts on generated reports by CBNA or vendors, primarily delinquent property tax reports Prepares and or reviews invoices for third party payouts Researches, tracks, and follow ups on borrower adherence

of Job Ensure prompt, efficient, accurate and timely claims adjudication of high dollar claims in accordance with the current policy benefits, limitations or exclusions. Provide resolution of provider inquiries and collaborate with internal departments. Provide feedback or suggestions to enhance current processes and/or systems. Responsibilities Research and adjudicate hig

Case Management Associate (High Risk OB, Social Determinants of Health) Job Ref 102738 Category Professional Department CASE MANAGEMENT PROGRAM Location 50 Water Street, 7th Floor, New York, NY 10004 Job Type Regular Employment Type Full Time Hire In Rate $50,000.00 Salary Range $50,000.00 $50,000.00 Empower. Unite. Care. MetroPlusHealth is committed to empowering New Yor

MetroPlusHealth Summer Internship Claims Job Ref 103125 Category Claims Department CLAIMS Location 50 Water Street, 7th Floor, New York, NY 10004 Job Type Regular Employment Type Full Time Salary Range $17.00 $17.00 Empower. Unite. Care. MetroPlusHealth is committed to empowering New Yorkers by uniting communities through care. We believe that Health care is a right, not

JOB DESCRIPTION Position Type Full time Type Of Hire Experienced (relevant combo of work and education) Travel Percentage 1 5% FIS is a leading provider of technology solutions for merchants, banks and capital markets firms globally. FIS stays ahead of how the world is evolving to power businesses in today's fast changing competitive landscape and help our clients run, gr

Assist in end to end provider claims and help enhance call quality Assist in efforts to enhance ease of use of physician portal and future services enhancements Contribute to design and implementation of programs that build/nurture positive relationships between the health plan, providers and practice managers Support development and management of provider networks Help i

JOB DESCRIPTION Position Type Full time Type Of Hire Experienced (relevant combo of work and education) Education Desired Bachelor of Business Management Travel Percentage 10 15% Job Description Are you curious, motivated, and forward thinking? At FIS you'll have the opportunity to work on some of the most challenging and relevant issues in financial services and technolo