Top 196 Coding quality analyst Jobs in New York, Ny

Claims Quality Analyst
MetroPlusHealth —New York, NY
- $55,000 - $65,000 a year
- Word processing
- Mid-level
- Continuous improvement
- Commuter assistance
- Paid holidays
Quick Apply
Software Engineer Analyst - AI Trainer
DataAnnotation —Glen Cove, NY
- $50 - $100 an hour
- Part-time
- Remote
- Writing skills
- English
- Mid-level
- Flexible schedule
Quick Apply
Software Engineer Analyst - AI Trainer
DataAnnotation —Hoboken, NJ
- $50 - $100 an hour
- Part-time
- Remote
- Writing skills
- English
- Mid-level
- Flexible schedule
Quick Apply
Product Analyst - AI Trainer
DataAnnotation —Hempstead, NY
- $40 - $60 an hour
- Part-time
- Remote
- Computer Science
- English
- Mid-level
- Flexible schedule
Quick Apply
Director ETL and Data Engineering
Church Pension Group Services Corporation —New York, NY
- $136,000 - $180,000 a year
- Full-time
- Hybrid work
- Office
- 3 years
- Travel
- Commuter assistance
- AD&D insurance
Supply Chain Analyst - AI Trainer
DataAnnotation —Greenburgh, NY
- $40 - $60 an hour
- Part-time
- Remote
- Computer Science
- English
- Mid-level
- Flexible schedule
Quick Apply
Intermodal Chassis and Container Inspector
Aspect Associates, LLC —Jersey City, NJ
- $55,000 - $60,000 a year
- Full-time
- Background check
- Microsoft Excel
- Microsoft Outlook
- Health savings account
- Health insurance
Quick Apply
Legal Technology Data Solutions Specialist
Career Developers —Manhattan, NY
- $120,000 - $130,000 a year
- Hybrid work
- Microsoft Excel
- 5 years
- Bachelor's degree
Quick Apply
9d
RME Planner
C&W Services —Jersey City, NJ
- $35.11 - $41.30 an hour
- Full-time
- Oracle
- Computer Science
- Engineering
- Health savings account
- Disability insurance
Quick Apply
4d
Senior Java Developer, Vice President
Citi —Jersey City, NJ
- $142,320 - $213,480 a year
- Full-time
- 6 years
- System design
- Office
- Paid holidays
- Disability insurance
7h
Revenue Cycle AI Operations Analyst
Hospital for Special Surgery —New York, NY
- $72,000 - $109,500 a year
- Full-time
- Mid-level
- Mentoring
- In-person
Medical Coding Analyst
HealthCare Partners, MSO —Garden City, NY
- $65,000 - $75,000 a year
- Full-time
- Anatomy knowledge
- Mid-level
- High school diploma or GED
- Health insurance
- Dental insurance
Data Analyst
Columbia University —New York, NY
- $65,300 - $89,800 a year
- Full-time
- Computer Science
- Mid-level
- C++
Junior Analyst - RFP AI
StepStone Group —New York, NY
- $30 an hour
- Hybrid work
- 18 years or older
- Research
- Finance
Claims Review Analyst
EmblemHealth —New York, NY
- $48,600 - $83,160 a year
- Mid-level
- Analysis skills
- Bachelor's degree
11d
Temporary Data Request Analyst
Uncommon Schools —New York, NY
- $67,300 - $79,200 a year
- Full-time
- Office
- Analysis skills
- Bachelor's degree
- 403(b) matching
- Health savings account
Quick Apply
Business and Systems Analyst
FINANCIAL INFO SVCS AGENCY —Manhattan, NY
- $140,000 - $166,500 a year
- Full-time
- Computer Science
- Mid-level
- Office
- Commuter assistance
- Health insurance
11d
Data & Metrics Analyst
CAMPAIGN FINANCE BOARD —Manhattan, NY
- $80,001 - $90,000 a year
- Full-time
- Computer Science
- Writing skills
- Mid-level
- Loan forgiveness
5d
Software Quality Assurance Analyst
XoriantːUS —Edison, NJ
- Computer Science
- Office
- Bachelor's degree
Claims Quality Analyst
MetroPlus Health Plan —New York, NY
- $55,000 - $65,000 a year
- Full-time
- Word processing
- Mid-level
- Office
- Commuter assistance
- Paid holidays

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coding quality analyst jobs near new york, ny

Claims Quality Analyst

MetroPlusHealth -
New York, NY

Quick Apply

Job Details

$55,000 - $65,000 a year

Benefits

Commuter assistance
Paid holidays
Health insurance
Pension plan
Union benefits
Employee discount
Loan forgiveness

Qualifications

Medicare
Managed care
Managed care organization experience
Health insurance policy knowledge
CMS
Medical coding experience in physician offices
CMS regulatory compliance
Quality assurance audits
Medicare regulations
Centers for Medicare & Medicaid Services (CMS) billing regulations
Quality audits
Associate's degree
Healthcare coding investigations
Medical terminology
Analytics

Full Job Description

Empower. Unite. Care.

MetroPlusHealth is committed to empowering New Yorkers by uniting communities through care. We believe that Health care is a right, not a privilege. If you have compassion and a collaborative spirit, work with us. You can come to work being proud of what you do every day.

About NYC Health + Hospitals

MetroPlusHealth provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc. As a wholly-owned subsidiary of NYC Health + Hospitals, the largest public health system in the United States, MetroPlusHealth's network includes over 27,000 primary care providers, specialists and participating clinics. For more than 40 years, MetroPlusHealth has been committed to building strong relationships with its members and providers.

Position Overview

The Claims Quality Analyst 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 and Plan’s established guidelines and/or policies and procedures. The incumbent will research, review, and suggest process improvements, training opportunities and is a resource of information to all staff. The incumbent will also perform special projects.

Work Shifts

9:00 A.M – 5:00 P.M

Duties & Responsibilities

Audit daily processed claims through random selection based on set criteria.
Document, track, and trend findings per organizational guidelines
Based upon trends, determine ongoing Claims Examiner training needs, and assist in the development of training curriculum.
Conduct in-depth research of contract issues, system-related problems, claims processing Policies and Procedures, etc., to confirm cause of trends. Recommend actions/resolutions.
Work with other organizational departments to develop corrective action plans to improve accuracy of the claims adjudication processes and assure compliance with organizational
requirements and applicable regulations
Assist in the development of Claims policies and procedures
Provide backup for other trainers within
the department
Assist in training of new departmental staffs
Assist with the research and resolution of audit appeal
Asist with external/internal regulatory audits
Identify policies or common errors requiring retraining sessions.
Participate in quality projects as required.
Collect, analyze data, identify trends, write reports (i.e., the monthly and quarterly reports) and present findings to the appropriate claims service management personnel.
Other duties as assigned by senior management

Minimum Qualifications

Associate degree required; Bachelor’s degree preferred
Minimum of 4 years of experience performing claims quality audits in a NYS-based managed care setting
Expertise in both professional and institutional claims coding, and coding rules required.
Definitive understanding of provider and health plan contracting, delineation of risk, medical terminology and standard industry reimbursement methodologies required.
Strong knowledge of CMS Medicare and NYS regulations required.
Experience in training development and presentation preferred

Professional Competencies

Strong organizational, analytical, and oral/written communication skills required.
Proficiency in PC application skills, e.g., excel, word, PowerPoint, etc.,
Must be able to follow direction and perform independently according to departmental
Integrity and Trust
Must have excellent interpersonal, verbal, and written communication skills

#LI-Hybrid

#MHP50

Benefits

NYC Health and Hospitals offers a competitive benefits package that includes:

Comprehensive Health Benefits for employees hired to work 20+ hrs. per week
Retirement Savings and Pension Plans
Paid Holidays and Vacation in accordance with employees' Collectively bargained contracts
Loan Forgiveness Programs for eligible employees
College tuition discounts and professional development opportunities
College Savings Program
Union Benefits for eligible titles
Multiple employee discounts programs
Commuter Benefits Programs

Quick Apply

Refine Your Search

coding quality analyst jobs in new york, ny

Claims Quality Analyst

Software Engineer Analyst - AI Trainer

Software Engineer Analyst - AI Trainer

Product Analyst - AI Trainer

Director ETL and Data Engineering

Supply Chain Analyst - AI Trainer

Intermodal Chassis and Container Inspector

Legal Technology Data Solutions Specialist

RME Planner

Senior Java Developer, Vice President

Revenue Cycle AI Operations Analyst

Medical Coding Analyst

Data Analyst

Junior Analyst - RFP AI

Claims Review Analyst

Temporary Data Request Analyst

Business and Systems Analyst

Data & Metrics Analyst

Software Quality Assurance Analyst

Claims Quality Analyst

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Empower. Unite. Care.

About NYC Health + Hospitals

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Benefits

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