- Molina Healthcare (Yonkers, NY)
- **JOB DESCRIPTION** **Job Summary** Responsible for administering claims payments, maintaining claim records. Monitors and controls backlog and workflow of ... claims . Ensures that claims are settled in...Procures all medical records and statements that support the claim . + Makes recommendations for further investigation or resolution.… more
- Northwell Health (New York, NY)
- **Req Number** 166205 Flexstaff is hiring a CLAIMS SPECIALIST on a fulltime Temporary basis. (Coding/ Claims experience needed, Data Analysis a plus) The ... will support department operations related to provider communication, pended claim review, reporting, auditing, and oversight activities to ensure compliance… more
- Molina Healthcare (Albany, NY)
- …clear and concise to ensure accuracy in auditing of critical information on claims ensuring adherence to business and system requirements of customers as it pertains ... prior authorizations, fee schedules, and other business requirements critical to claim accuracy. Maintain audit records, and provide counsel regarding coverage… more
- Molina Healthcare (Yonkers, NY)
- … claims adjusting and customer services experience Experience in QNXT, Salesforce, Claims Viewer, Claim Shark, PEGA, Cotiviti, ECHO, CEMs Edifecs **PHYSICAL ... Description** **Job Summary** Responsible for work load assignment to the provider Claims adjudicators and senior provider claims adjudicators. Train and coach… more
- Zurich NA (New York, NY)
- Legal Claims Professional - Financial Lines 126698 Zurich is currently looking for multiple Legal Claims Professionals for our growing Management Solutions group ... to work out of any of our Claims offices throughout the US. If you are ready...rights and coverage denial letters + Notify Underwriter of claim issues + Draft case summary reports in connection… more
- MetLife (Oriskany, NY)
- …activity (send a letter, return a call, refer to a case) as applicable. Review claims submission for completeness and accuracy. Records data in the Claims system ... to the Beneficiary. May also be responsible for setting up new claims , processing incoming mail, and handling expired call-ups. Principal Responsibilities: 1.… more
- Zurich NA (New York, NY)
- Sr. Claims Specialist - Complex Construction 126105 Zurich North America is seeking a skilled and experienced Senior Claims Specialist to join our Complex ... team. This role is essential in managing complex, high-exposure construction, and litigation claims , while supporting the New York Labor team to ensure claims … more
- City of New York (New York, NY)
- … for reimbursement to be submitted to State Agencies by using the NYS Automated Claim System (ACS). Claims for Federal and State Aid include monthly Statements ... BE PERMANENT IN A COMPARABLE TITLE ELIGIBLE FOR 6.1.9 TITLE CHANGE Bureau of Claims and Reimbursement (BCR) is responsible for the daily operations of the Bureau's… more
- MVP Health Care (Rochester, NY)
- …thinking and continuous improvement. To achieve this, we're looking for a Leader, Claims Operations, to join #TeamMVP. If you have a passion for leadership, team ... Minimum 3 years in health insurance or production-related environment. 2 years claims processing experience preferred. + Strong knowledge of Medicaid, Medicare, and… more
- Humana (Albany, NY)
- …industry + 2+ years of demonstrated expertise in end-to-end healthcare claims operations, including claim ingestion, processing, system navigation, payment ... your opportunity to lead cross-functional initiatives, apply your expertise in healthcare claims , and shape the future of operational excellence in a dynamic,… more