Emblemhealth jobs - Secaucus, NJ

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Apr 09 Lead Business Data Analyst (New York) Emblemhealth New York, NY

Performs other duties as assigned or required Knowledge of claims operations processes (authorizations, claims, provider set-up, etc Develop presentations and reports for middle... more

Apr 08 Sr. Rates Specialist Emblemhealth New York, NY

Summary: Ensure that all facility contracts received are logged, reviewed and loaded accurately in the contracting system (Qcare). Respond accurately and timely to contract... more

Apr 08 Dir.,Payment Reconciliation Emblemhealth New York, NY

process of payment reconciliation for all EmblemHealth medical and hospital claims across all legacy platforms. • Develop system and process workflows and controls to address all... more

Apr 08 Lead Business Data Analyst Emblemhealth New York, NY

Execute a variety of complex analytical exercises to provide operations and medical management with actionable, high quality quantitative information that drives effective... more

Apr 07 Mgr., Reimbursement Management Emblemhealth New York, NY

accurate reconciliation of payments of all EmblemHealth medical and hospital claims across all legacy platforms. * Manage process workflows and controls to address all... more

Apr 05 Grievance & Appeal Specialist Emblemhealth New York, NY

Responds to written/verbal grievances, complaints, appeals and disputes submitted by members and providers in accordance with NCQA, CMS, NY State and other regulations. Types of... more

Apr 05 Credentialing Specialist Emblemhealth New York, NY

Conduct activities related to initial credentialing, recredentialing, delegation, facility credentialing and ongoing provider file maintenance. Conduct all processes to remain... more

Mar 26 Dir., Testing Emblemhealth New York, NY

Summary:Oversees the planning, assists with definition of requirements, testing, implementation, management and improvements of all QCARE applications to process professional and... more

Mar 17 Lead Operations Reporting Analyst Emblemhealth New York, NY

Summary of Position The Lead Operations Reporting Analyst for Special Populations will develop, manage, and monitor a variety of complex analytical and reporting capabilities... more

Mar 13 Labor/Large Grp Rep Emblemhealth New York, NY

correspondence and prospectuses.Provide EmblemHealth with market intelligence in ... on competitive advantages.Represent EmblemHealth at community, civic, and... more

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