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

Displaying all 10 results
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

Health Care Claims Analyst (Benefits Design Analyst)

Healthfirst - New York, NY
Responsibilities: Benefits Design Analysis: Assist in the on-going evaluation of benefits configuration for new and existing benefit plans within PowerMHS. Analyze explanation of coverage documents to assist with determining best approach for loading benefits offered including member cost share and out-of-pocket maximums. Assist in the setup of co...
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

Business Analyst (Claims Analytics)

Healthfirst - New York, NY
Responsibilities: Analysis, Reporting and Performance Improvement: Analyze various types of data and processes in a versatile manner and present findings and recommendations in a professional manner. Manipulate data to root cause, trend, summarize findings and offer recommendations. Identify defects and improve departmental performance by supporti...
Application Deadline: None
Healthfirst

Manager, Claims Analytics

Healthfirst - New York, NY
Responsibilities: Unit Management and Oversight Responsible for the performance and resource management as well as oversight of the Claims Business Analytics Unit while defining and coordinating departmental projects, scope and objectives. Identifies, assigns, coordinates and manages the work assignments for Business and Operation Analyt...
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

Manager, Network Management

Healthfirst - New York, NY
Responsibilities: Develop a team whose role is to advance Healthfirst in the provider market by focusing on objectives, core principles, consistent communication, and staff coaching and development Supports the team and emphasizes the overall goal of superior customer service and engagement by guiding staff on prioritization, escalation protocol, decision tree framework, an...
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
Healthfirst

Business Analyst Project Analytics (Billing and Reconciliation)

Healthfirst - New York, NY
Responsibilities: As the subject matter expert, represent the billing and enrollment department on all projects and company initiatives. Define business requirements for each project or company initiative. Work with information systems department to ensure business requirements are clearly understood and solutions are presented to meet the requirements.
Application Deadline: None
Displaying all 10 results