- SUNY Geneseo (Geneseo, NY)
- …Job Duties/Responsibilities Percentage Of Time 30% Job Duty/ Responsibility Function 1: Case Adjudication + Adjudicates level I and level II cases in alignment with ... Assist with hearing board recruitment and training, and scheduling members for the adjudication of cases. Percentage Of Time 5% Job Duty/ Responsibility Function 5:… more
- UHS (Binghamton, NY)
- …impacting payment calculations, playing a vital role in resolving system adjudication issues and identifying necessary corrections. At UHS, every connection ... Audit expected reimbursements and validate HealthPlan payments, identifying and resolving adjudication issues. + Maintain clear communication on project progress and… more
- Catholic Health Services (Centereach, NY)
- …EMR platforms + Experience with retail pharmacy prescription processing and claims adjudication + Prior experience on pharmacy dispensing systems and familiar with ... insurance adjudication processes + This role involves working with a broad array of complex disease states and medical conditions. Candidates should be comfortable… more
- Pacific Northwest National Laboratory (Albany, NY)
- …of federal background investigation post hire and receive a favorable federal adjudication . The tier of federal background investigation will be determined by job ... duties and national security or public trust responsibilities associated with the job. All tiers of investigation include a declaration of illegal drug activities, including use, supply, possession, or manufacture within the last 1 to 7 years (depending on the… more
- Sedgwick (Albany, NY)
- …higher-level general auto claims to determine scope of damages; to ensure ongoing adjudication of claims within company standards and industry best practices; and to ... identify subrogation of claims and negotiate settlements. **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Manages mid-level and higher-level auto commercial and personal lines claims by gathering information to determine exposure; assigns reserve values to… more
- City of New York (New York, NY)
- …Finance business centers, City Register's Office, and the Land Records, Adjudication , and Collections divisions. Customer Operations is charged with the processing ... of tax payments, parking violations payments, and all other charges collected by DOF. The division is also responsible for recording property transfers, adjudicating parking and camera violations, and managing the full life cycle of the department's… more
- New York State Civil Service (New York, NY)
- …allowed? Yes County New York Street Address NYS DOCCS - Board of Parole - Adjudication Bureau 314 West 40th Street City New York State NY Zip Code 10018 Duties ... Description To be discussed at time of interview. Travel percentage 50%. Minimum Qualifications Admission to the bar of the State of New York, and either; four years of full-time post-bar legal experience, including two years of courtroom experience or… more
- Highmark Health (Albany, NY)
- …Enter all authorizations into the Argus IPNS information system to allow claim adjudication . + Complete other assigned duties as specified. + Identify and report ... improper coordination of benefit billing practices through paid clams review. + Participate as pharmacy representative in onsite member appeals and grievances sessions. + Serve as a resource for technical staff. + Other duties as assigned or requested.… more
- Humana (Albany, NY)
- …first** **Requires a strong foundation in COBOL mainframe development ** The Claims Adjudication System (CAS) team at Humana is essential in delivering core services ... through effective claims processing and management solutions. This position involves coding software applications based on business requirements and addressing moderately complex to complex issues through in-depth analysis. **Responsibilities** + Code software… more
- Centene Corporation (New York, NY)
- …HCPC reimbursement methodologies. + Documents rate negotiation accurately for proper claims adjudication . + Acts as liaison between the TRICARE beneficiary and the ... provider, facility and the MTF to utilize appropriate and cost effective medical resources within the direct care and purchased care system. + Identifies and refers potential cases to Disease Management, Case Management, Demand Management and Transitional… more