- Sedgwick (Albany, NY)
- …high exposure claims involving litigation and rehabilitation; to ensure ongoing adjudication of claims within service expectations, industry best practices and ... specific client service requirements; and to identify subrogation of claims and negotiate settlements. **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Analyzes and processes complex or technically difficult claims by investigating and gathering information to… 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
- Hannaford (Albany, NY)
- …in maintenance of third party prescription information and resolution of rejected adjudication . * Initiate prescription renewal requests to doctor via telephone call ... or fax where applicable by law. * Understand pharmacy inventory control procedures, including special requirements for controlled substances. * Receive and obtain information needed on written prescriptions or telephoned refill requests from customers. *… more
- Price Chopper (Watertown, NY)
- …prescription medications, including maintenance of necessary records, accurate third-party adjudication and patient charges, and inventory management. + Counsels ... patients and medical providers regarding the nature and use of drugs, dosage, drug interactions, and side effects. + Participates in patient centered services including immunization, MTM, and wellness programs. + Supervises personnel in the daily operation of… more
- Parexel (Albany, NY)
- …with experts and active contribution to site engagement. Support of Endpoint Adjudication (EA), Data Monitoring Committee (DMC), Data Safety Monitoring Boards (DSMB) ... and Steering Committees (SC) (as applicable), by presenting medical content of study to the respective committees, responding to medical questions and by ensuring good quality of data from CQM perspective. + Medical questions are responded in a timely manner… more
- City of New York (New York, NY)
- …the ages of 13 and 20 ordered held by a judge, pending the adjudication of their case. The selected candidate will be responsible for performing the following ... duties but not limited to: - Assume executive level authority for facility-wide operations in the absence of the Associate Commissioner of Horizon and other facility leadership. - Direct and manage Group Services operations and personnel 24/7 and respond to… more
- KPH Healthcare Services, Inc. (Chittenango, NY)
- …of pharmacy technology - included is product dispensing, data entry, and adjudication workflow step + Insure that every prescription has been checked by ... a pharmacist prior to dispensing to the patient + Assist in the initial submission, and resubmission (as required) of all third-party claims + Inventory management - proficient in inventory management including ordering & receiving processes, inventory… more
- Sedgwick (Albany, NY)
- …of our valued clients to determine benefits due, while ensuring ongoing adjudication of claims within service expectations, industry best practices, and specific ... client service requirements. **ESSENTIAL RESPONSIBLITIES MAY INCLUDE** + Analyzing and processing claims through well-developed action plans to an appropriate and timely resolution by investigating and gathering information to determine the exposure on the… more
- City of New York (New York, NY)
- …workforce; and to providing a prompt, fair, and impartial review, and adjudication of discrimination complaints. One of the OEEO's responsibilities' is the ... processing of requests for reasonable accommodations. A Reasonable Accommodation (RA) Request is a modification or adjustment to a job, work environment, or way things are usually done during the hiring process. RA's allow eligible employees and applicants to… more
- Evolent (Albany, NY)
- …Works closely with the appeals-dedicated Clinical Reviewers to ensure timely adjudication of processed appeals. + Other duties as assigned. **Qualifications Required ... and Preferred:** + 1-3 years' experience and as an RN - **Required** + Minimum of 5 years in Utilization Management, health care Appeals, compliance and/or grievances/complaints in a quality improvement environment- **Required** + Able to work in a rotation to… more
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