Job description

Staffing Solutions Organization LLC (SSO), an affiliate of Public Consulting Group LLC (PCG), is focused on delighting clients with world-class managed staffing and talent consulting services. SSO is committed to a diverse workforce, which is a reflection of our clients and the people they serve.

Healthcare Program Associate – Pended Claims Review in Menands, NY
Item 1317

Summary:
The Division of Medical and Dental Directors, Bureau of Medical Review is recruiting for Healthcare Program Associate to assist the Bureau in day-to-day operations for the Pended Claims Unit. The Bureau of Medical Review is responsible for prior approval and pre-payment review of medical equipment and service, policy development as well as fraud and abuse monitoring for the New York State Medicaid System. The Pended Claims Unit focuses on process improvement resulting in cost savings and staff efficiencies.

Duties include:

• Using established instructions perform complex medical claims adjudication, including pricing of claims.
• Handle complex phone calls regarding pended claim issues and promptly respond to provider inquires.
• Supervise and train subordinate SSO staff in claims review and perform quality assurance reviews to maintain accuracy and consistency of claims reviews.
• All other activities necessary to maintain defined regulatory claims review timelines

Basic Qualifications:

• 2 years of experience in healthcare field
• An Associate’s degree can count as two years of experience, a Bachelor’s degree can count as four years of experience, and a Master’s degree can count as five years of experience.

Preferred Qualifications:

• Proficient in the use of standard office technology
• Excellent organizational skills including the ability to prioritize work assignments
• Ability to be flexible, innovative, and work independently with minimal supervision and as a team lead
• Strong communication skills (written and verbal) with the ability to handle internal and external calls/inquiries
• Maintains a positive, professional demeanor
• Previous customer service experience

Compensation for roles at Staffing Solutions Organization LLC (SSO) varies depending on a wide array of factors including, but not limited to, the specific office location, role, skill set, and level of experience. As required by applicable law, SSO provides the following reasonable range of compensation for this role. In addition, SSO provides a range of benefits for this role.

Compensation for roles at Staffing Solutions Organization LLC (SSO) varies depending on a wide array of factors including, but not limited to, the specific office location, role, skill set, and level of experience. As required by applicable law, SSO provides the following reasonable range of compensation for this role. In addition, SSO provides a range of benefits for this role.

All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sexual orientation, gender identity, marital status, age, national origin, protected veteran status, or disability. Staffing Solutions Organization LLC is an e-Verify participant.

www.colinoncars.com is the go-to platform for job seekers looking for the best job postings from around the web. With a focus on quality, the platform guarantees that all job postings are from reliable sources and are up-to-date. It also offers a variety of tools to help users find the perfect job for them, such as searching by location and filtering by industry. Furthermore, www.colinoncars.com provides helpful resources like resume tips and career advice to give job seekers an edge in their search. With its commitment to quality and user-friendliness, www.colinoncars.com is the ideal place to find your next job.