• Workers Compensation Claims Team Lead | NY…

    Sedgwick (Syracuse, NY)
    …with management projects for the office. + Provides technical/jurisdictional direction to examiner reports on claims adjudication. + Compiles reviews and ... reserve amounts on high cost claims and claims over the authority of the individual examiner...claim status; and provides written resumes of specific claims as requested by client. + Assures that direct… more
    Sedgwick (08/20/25)
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  • Specialist, Configuration Oversight (Healthcare…

    Molina Healthcare (Albany, NY)
    …updates/changes within claims processing system . + Experience using claims processing system (QNXT). ** PREFERRED EDUCATION:** Bachelor's Degree or ... equivalent combination of education and experience ** PREFERRED EXPERIENCE:** 3+ years Healthcare Claims Adjudication **PHYSICAL DEMANDS:** Working environment is… more
    Molina Healthcare (08/16/25)
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  • RN Crisis Care Triage

    Sedgwick (Albany, NY)
    … claim . + Maintains communication with the customer, Client Service Director, and Claims Examiner providing timely updates on changes in injured worker status ... guidelines. + Maintains ongoing communication with the client, Client Service Director, and Claims Examiner until the assigned Field Case Manager arrives onsite.… more
    Sedgwick (07/25/25)
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  • FEMA Disaster Management Accountant

    CDM Smith (Albany, 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...potential fraud, and ensure the integrity and fairness of claim settlements. By applying advanced accounting, auditing, and investigative… more
    CDM Smith (08/01/25)
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  • Sr. Director, Payment Integrity & Cost Containment

    MVP Health Care (Schenectady, NY)
    …Integrity & Cost Containment** to lead enterprise-wide initiatives that ensure claims are paid accurately, ethically, and efficiently. This high-impact role ... goals. + Oversee pre- and post-payment integrity programs including claims editing, audits, subrogation, readmission reviews, and coordination of benefits.… more
    MVP Health Care (08/20/25)
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  • Crime Victim Advocate: Homicide Specialist

    City of New York (New York, NY)
    …through interactions with law enforcement, the criminal justice system, the medical examiner 's office, and others as necessary. This position will report directly to ... families to determine their needs. Help homicide survivors navigate the Medical Examiner 's Office, liaise with Bronx Homicide Detectives, and explain the Criminal… more
    City of New York (08/13/25)
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  • Investigator

    Highmark Health (Albany, NY)
    …+ None ** Preferred ** (any of the following) + Certified Fraud Examiner (CFE) + Certified Professional Coder (CPC) + Certified Outpatient Coder (COC) + ... 6 years of related and progressive experience in lieu of Bachelor's degree ** Preferred ** + Master's Degree in Fraud, Forensics Accounting, Business or related field… more
    Highmark Health (08/15/25)
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