- BronxCare Health System (Bronx, NY)
- …collection, analysis, implementation of and compliance with risk management and claims activities, support of and participation in Continuous Quality Improvement ... * Participate in weekly staff meetings, regular supervision meetings and in case management meetings as needed. * Participate in staff development. * Establish… more
- Travelers Insurance Company (Albany, NY)
- …reserve, negotiate and resolve the company's most severe and/or complex claims , in multiple jurisdictions, in accordance with Best Practices. Provide quality ... claim handling and superior customer service on assigned claims , while engaging in indemnity & expense management. Promptly...of policy information to facts or allegations of each case . + Directly investigate each claim through prompt and… more
- Travelers Insurance Company (Melville, NY)
- …with insured based on application of policy information to facts or allegations of each case . + Consults with Manager on use of Claim Coverage Counsel as needed. ... and resolving assigned General Liability Bodily Injury and Property Damage claims . Provides quality claim handling throughout the claim life cycle (customer… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …policies and procedures and related health plan functions such as member services, claims , and the referral process. As well as functions related to legislative and ... the Health Plan Essential Accountabilities: Level I + Review / prep clinical case for clinical staff. + Navigates and utilizes corporate applications; core claims… more
- Travelers Insurance Company (Melville, NY)
- …with insured based on application of policy information to facts or allegations of each case . + Consults with Manager on use of Claim Coverage Counsel as needed. ... and resolving assigned Specialty Liability Bodily Injury and Property Damage claims . Provides quality claim handling throughout the claim life cycle (customer… more
- New York State Civil Service (New Windsor, NY)
- …firefighting, volunteer ambulance workers, or paid family leave discrimination claims using a stenographic machine and computer-aided transcription, specifically ... Case CATalyst software, to create an accurate verbatim transcript.*...volunteer firefighting, volunteer ambulance workers, discrimination, or disability benefits claims contemporaneously with the speaker reflecting a true and… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …compliance and regulatory requirements. Primary activities include substantiating referrals, case planning and research, conducting onsite or desk audits, clinical ... in a clear and concise manner. + Analyzes proactive detection reports and claims data to identify red flags/aberrant billing patterns. + Manages cases as assigned,… more
- Molina Healthcare (Albany, NY)
- …Certified Clinical Coder (CCC), Certified Medical Audit Specialist (CMAS), Certified Case Manager (CCM), Certified Professional Healthcare Management (CPHM), ... Duties** + Facilitates clinical/medical reviews of retrospective medical claim reviews, medical claims and previously denied cases in which an appeal has been made,… more
- CDM Smith (Woodbury, NY)
- …Smith is seeking a Forensic Accounting Specialist with expertise in disaster fraud claims . This role is critical in evaluating and analyzing financial data related ... to disaster-related claims , including property damage, business interruption, and other loss...Smith Placement Agreement from the CDM Smith Recruitment Center Manager to receive payment for your placement. Verbal or… more
- Uniland Development Company (Amherst, NY)
- …responsibilities of this position include managing Uniland's insurance policies and claims processes, assisting with claim and incident resolution and litigation ... pertaining to Uniland's business activities. + Facilitates administration of insurance claims , including builder's risk, liability, and property insurance and other… more