8 Insurance Job Openings at Healthfirst Within 25 mi. of New York, NY

Displaying all 8 results
Healthfirst

Claims Operation Analyst (Network Analyst/Provider Data Analyst)

Healthfirst - New York, NY
Responsibilities: Analysis, Reporting and Performance Improvement : Analyze provider setups and network data processes. Review technical specifications to ensure the Department business requirements are adequately reflected in technical planning documents. Prepare routine reports as needed (network, financial, quality, productio...
Application Deadline: None
Healthfirst

Network Management Representative (5 Boroughs)

Healthfirst - New York, NY
Responsibilities: Serve as plan liaison for physician/physician groups as assigned. Point of contact for all plan-related issues. Complete audit of new provider set up for appropriateness (demographics, fee schedules, Lines of Business, etc.). Ensure accuracy of Provider set up in order to resolve any complaints and/or issues. Maintain record of all new Providers. An agenda w...
Application Deadline: None
Healthfirst

Claims Reimbursement Analyst

Healthfirst - New York, NY
Responsibilities: 1. Create and Maintain Claims Reimbursement Methodologies Analyze contract terms, prepare fee schedules and accurately document file changes into the claims processing system(Managed Healthcare System, MHS). Implement through Information Services (IS) MHS features needed for accurate payments.
Application Deadline: None
Healthfirst

Managed Service Organization (MSO) Account Representative

Healthfirst - New York, NY
Responsibilities: Review and maintain MSO requests ensuring quality standards and expectations are met. This includes, but is not limited to, responsibilities for MSO communication, conflict resolution and compliance. This will be managed by the MSO Manager through weekly and monthly planning meetings with expectation of collaboratively achieving structure and consistent communication inter...
Application Deadline: None
Healthfirst

Business Analyst (Provider Data/Network Analyst)

Healthfirst - New York, NY
Responsibilities: Analysis, Reporting and Performance Improvement: Analyze provider data processes and present findings. Work cross-functionally to recommend and request modifications to existing system processes addressing deficiencies and/or further improving and streamlining performance. Review technical specifications to ensure Dep...
Application Deadline: None
Healthfirst

Director, Hospital Relations

Healthfirst - New York, NY
Responsibilities: Serve as key liaison for all hospital-affiliated Providers. Oversee all aspects of hospital relationship management with staff to ensure a high performance hospital network. Ensure team has a strong focus on engagement with hospital network and deliver superior customer service which include but is not limited to: timely responses and follow-up ...
Application Deadline: None
Healthfirst

Claims Examiner

Healthfirst - New York, NY
Responsibilities: Review, investigate and adjudicate claims and encounters for medical services through contractual provisions in accordance with provider contracts and authorizations. Process new claim suspensions and reprocess (as needed) for discrepancies; as well as review other documentation for edits and consistency. All errors must be documented according to Healthfi...
Application Deadline: None
Healthfirst

Assistant Director, Physician Relations

Healthfirst - New York, NY
Responsibilities: Responsible for the daily operational processes within the Physician Relations department which include reviewing and revising said processes. Identifies areas of improvement and works with internal departments to streamline processes. Trains, coaches and mentors staff based on these processes, manages performance, and identifies areas of improvement for further trai...
Application Deadline: None
Displaying all 8 results