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Our Members’ First Line of Support

Healthfirst provides members with quality care. Our Operations team members are the first line of support directly assisting our members. These teams collaborate to streamline processes that drive positive change. Interested in joining our Operations team? Check out our available positions listed below.

Open Positions in Operations

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Claims Modernization - Process Engineer

NY Req ID: R020178 Hybrid
Duties & Responsibilities:Unified Process Improvement: Support the modernization of claims and provider payment processes to achieve alignment between operations and technology.Process Mapping and Value Stream Mapping (VSM): Develop detailed process maps and value stream analyses to identify...
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Manager Enrollment and Billing

NY Req ID: R020160 Hybrid
Duties and Responsibilities:Oversee the enrollment process, ensuring timely and accurate processing of new and modified enrollments, renewals, and terminations.Collaborate with internal teams (e.g., sales, customer service, compliance) to ensure seamless management of members.Monitor ,report, and...
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QA Auditor, Appeals and Grievances

NY Req ID: R020413 Remote
Conduct quality audits of A&G items including grievances, pre-service appeals, and post service appeals utilizing appropriate sources of information; including eligibility, claims, authorizations, service forms, faxes, and any additional information required to complete the request. Analyze...
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Sr. Claims Coding Analyst

NY Req ID: R020231 Hybrid
Duties & Responsibilities: Analyze and interpret health insurance benefits and coverage details to apply appropriate medical codes.Accurately assign procedure (CPT, HCPCS) and diagnosis codes (ICD-10) represent patient services, treatments, copays, and coinsuranceVerify coding accuracy to...
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