- City of New York (New York, NY)
- … Claims Division. 11) Performing other related duties as directed. ADMINISTRATIVE CLAIM EXAMINER - 10044 Qualifications 1. A baccalaureate degree from an ... Bureau of Law and Adjustment (BLA), negotiates and approves all monetary settlement of claims and lawsuits involving the City of New York. BLA investigates and, when… more
- Sedgwick (Albany, NY)
- …accredited college or university preferred. **Experience** 2-3 years experience processing work comp claims as an examiner . Familiar with CPT, DRG and resources ... to Work(R) Fortune Best Workplaces in Financial Services & Insurance Work Comp Claims Negotiator **PRIMARY PURPOSE** **:** To negotiate Out of Network bills that do… more
- City of New York (New York, NY)
- …is a fast-paced environment and has a demanding workload. The Hearing Examiner /Officer must be fair, impartial, disinterested, and ensure that litigants are afforded ... due process. The Hearing Examiner /Officer must ensure that administrative hearings adhere to the procedural requirements of Federal Consent Decrees which gave rise… more
- Travelers Insurance Company (Queens, NY)
- …equipment breakdown, and overall insurability. Investigate less complex Equipment Breakdown claims as requested by the claim department. Evaluate elements ... recommending corrective actions. Work cooperatively with Boiler and Machinery underwriting and claim groups, in support of helping them make informed decisions to… more
- Molina Healthcare (NY)
- …enforcement or for payment recovery. **KNOWLEDGE/SKILLS/ABILITIES** + Reviews post pay claims with corresponding medical records to determine accuracy of claims ... of experience working in the group health business preferred, particularly within claims processing or operations. + A demonstrated working knowledge of Local, State… more
- City of New York (New York, NY)
- …advocacy through interactions with law enforcement, the criminal justice system, the medical examiner 's office, and others as necessary. The goal of this program is ... Detectives. - Assist homicide survivors in navigating the medical Examiner 's office. - Provide immediate emotional support and offering...with the completion of and filing of victim compensation claims with NYS OVS. - Prepare letters and forms… more
- New York State Civil Service (Endicott, NY)
- …only Case Manager in the NYS Segment.* Work-up and process Workers' Compensation claims .* Approve and deny medical bills.* Respond to claimant and provider inquiries ... via phone and email.* Routinely communicate with employers to obtain info about claims .* File forms and correspond with the Workers' Compensation Board.* Review … more
- City of New York (New York, NY)
- …for all medically related issues for medical management of workers' compensation claims . Responsibilities include: Consult managerial and legal staff in regards to ... not related to the claimant's job related injury. Assist examiner and legal staff to determine compensability of treatment...work injury and assist with medical case management of claims . Review and process high value and complicated in-patient… more
- New York State Civil Service (New York, NY)
- …investigation of alleged fraud.* Designation as a Certified Fraud Examiner .* Experience with statistical sampling and/or advanced statistical training.* Knowledge ... medical coding concepts (CPT, ICD-9 / 10, DRGs) and/or experience analyzing health care claims data.* A CPA is not required; but the position qualifies for CPA… more