- City of New York (New York, NY)
- …responsible specialized administrative work supervising the functions of the City-wide Claims Units and/or supervising the functions of the City-wide Special ... Projects Units. The City-wide Claims Units are responsible for determining if Food Stamp claims should be filed on cases with change actions resulting in a… more
- Independent Health (Buffalo, NY)
- …and Windows experience required, including typing skills. + Familiarity with on-line claim systems preferred. + Demonstration of math aptitude for purposes of ... basis. Assist in interpreting database information as it relates to pharmacy claims processing. + Assist with PBM implementation by identifying potential issues and… more
- Hannaford (New Hartford, NY)
- …forms after prescriptions are dispensed. * Prepare and complete manual insurance claim forms if needed. * Maintain organized filing system for invoices, manual ... insurance claims , daily reports, etc.. in accordance with Standard Practice...of third party prescription information and resolution of rejected claims . * Initiate prescription renewal requests to prescriber via… more
- Humana (Albany, NY)
- …operations for higher quality and operational efficiency. + Ensure enrollment and claims processes comply with regulatory requirements and guidelines. + Partner with ... and regulatory compliance. + Oversee resolution of member enrollment issues, claim disputes, and other reconciliation needs, especially during the Annual Enrollment… more
- City of New York (New York, NY)
- …and claiming data for data entry into multiple database systems for agency claims submitted annually for Federal and State reimbursement. - Analyze fiscal year ... claims , revenue, invoices and payment vouchers to ensure alignment...Agencies, Program areas and Vendors of status of relevant claim and payment schedules during the fiscal year. -… more
- Dal-Tile Corporation (New York, NY)
- …that an employee in this position would be expected to manage. Investigate claims submitted by customers to determine root cause, identify possible solutions, and ... coordinate actions with necessary functions to resolve replacement or remedial claims caused by manufacturing defects, addressing any disputes, and negotiating any… more
- HUB International (Melville, NY)
- …to in-force benefit programs through: + Generate and explain in layman's terms, projected claims , reserves and other key numeric indicators based on prior claims ... data from insurance carriers/third party administrators and other associated vendors ( claim reports, Geo Analysis, network effectiveness); + Reviewing proposals and… more
- Centene Corporation (Queens, NY)
- …to external provider related issues + Investigate, resolve and communicate provider claim issues and changes + Initiate data entry of provider-related demographic ... + Educate providers regarding policies and procedures related to referrals and claims submission, web site usage, EDI solicitation and related topics + Perform… more
- City of New York (New York, NY)
- …eligibility of Food Stamp benefits. - Verify the case folders for accurate claim establishment by accessing and checking the Welfare Management System (WMS), New ... other means for referral to the Supplemental Nutrition Assistance Program- Claims and Recovery (SNAP CR). - Review claims...Program- Claims and Recovery (SNAP CR). - Review claims calculations and make determination of whether to re-budget,… more
- City of New York (New York, NY)
- …Board. Division attorneys manage and litigate matters involving City employees whose claims for benefits are pending before the Workers' Compensation Board. They ... and legal research in preparation for hearings and evaluate the merits of claims . They regularly cross-examine fact witnesses as well as all types of medical… more