- Paychex (Rochester, NY)
- …quality improvements to reduce frequency rates, durations, and associated costs. Oversee claim resolution, settlement, and denials of WC's claims . Oversee vendor ... employee evaluations, to ensure consistent internal process are followed. + Ensures claims are handled in accordance with established quality and timeliness measures… more
- Utilities Service, LLC (Queens County, NY)
- …Background checks, etc. + Safety Management Process _(SMP)_ . Monitor and review current claims . + Work with the Home Office Claim Examiners and regional ... Management Department to question reserves, return to work status on current claims , surveillance, etc. Inform and communicate with your Safety Manager on weekly… 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
- Highmark Health (Albany, NY)
- …to several functions, including insurance premium and pricing development, claim trend analysis, experience studies, medical economics, profitability analysis, ... wellness studies, predictive modeling, benefit benchmarking, claim reserving and strategic client support that is both client facing and supportive to Sales… more
- Sedgwick (Albany, NY)
- …Adjusting **PRIMARY PURPOSE** **:** Completes non-complex projects related to claims operations including field, desk and estimating software activities; networks ... department management. Projects may involve various specialty practice areas of claims such as engineering, forensic accounting, and fire investigation. + Assists… more
- Stony Brook University (East Setauket, NY)
- …support day-to-day business functions including but not limited to: billing, claims analysis appeals, follow-up, financial assistance and customer service. **Duties ... are not limited to:** + Prepare and submit hospital claims . Review denials. Investigate coding issue. Audits. + Follow-up...coding issue. Audits. + Follow-up on rejected or denied claims , improper payments and coding issues. + Process appeals.… more
- Molina Healthcare (Rochester, NY)
- JOB DESCRIPTION Job Summary Leads and manages team responsible for claims activities including reviewing and resolving member and provider complaints, and ... oversees necessary correspondence in accordance with regulatory requirements. * Ensures claims production standards set by the department are met. * Maintains… more
- Sedgwick (Albany, NY)
- …you have just started your career, you are a leader in the industry, or a claims management expert looking for a new challenge, this is your chance to showcase your ... of clients across the globe, handling complex cases and claims + Collaborate with a talented and supportive team...to be accredited or qualified by experience + **Insurance claims experience:** it is imperative that you have experience… more
- Upstone Materials (Cairo, NY)
- …trackers. + Ensure timely issuance of contractual notices (eg, delay, disruption, claims ). + Monitor compliance with contractual obligations by all parties. ... & Variations + Prepare, assess, and negotiate variations, claims , and change orders. + Support the preparation of...+ Support the preparation of Extension of Time (EOT) claims and cost claims . + Maintain records… more
- Mount Sinai Health System (New York, NY)
- **Job Description** Responsible for ensuring unpaid and partially paid claims are resolved in an efficient and timely manner. Resolves EOB discrepancies and ... CPT and ICD (coding and CCI edits) + Electronic claims processing preferred. **Responsibilities** 1. Follows up on submitted... processing preferred. **Responsibilities** 1. Follows up on submitted claims , monitors unpaid claims and resubmits … more