• Medicaid Claims Processing, Associate,…

    MVP Health Care (Rochester, NY)
    …the accuracy of all provider, member and claim line information for all claims for which the examiner is responsible. + Knowledge of Facets and Macess ... continuous improvement. To achieve this, we're looking for a Claims Examiner to join #TeamMVP. If you...experience required + Knowledge of CPT, HCPCS, ICD-9-CM coding systems and Medical terminology preferred. + Strong PC skills… more
    MVP Health Care (11/27/25)
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  • Workers Compensation Claims Examiner…

    Sedgwick (Syracuse, NY)
    …to Work(R) Fortune Best Workplaces in Financial Services & Insurance Workers Compensation Claims Examiner | NY Jurisdiction | NY Licensing Preferred Job ... hybrid schedule** We are seeking a highly motivated and experienced Workers' Compensation Claims Adjuster/ Examiner to join our team. The ideal candidate will… more
    Sedgwick (11/07/25)
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  • Group Life Claim Reviewer

    MetLife (Oriskany, NY)
    …Group Life claim submissions to identify situations requiring referral to Claim Examiner . * Reviews data from various sources, including policyholders; ... appropriate media for input into a Windows based computer system (BIOS). * Respond to written and/or telephone inquiries...reviewing insurance claims . * Background in Life Claims ( Claim intake and Notice of Loss).… more
    MetLife (11/18/25)
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  • Risk Control Consultant Boiler & Machinery

    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
    Travelers Insurance Company (10/25/25)
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  • Lead Investigator, Special Investigative…

    Molina Healthcare (Rochester, NY)
    …abuse, and over utilization by providers and recipients. The position will review claims data, medical records, and billing data from all types of healthcare ... the Medicaid and Medicare programs as well as Marketplace + Understanding of claim billing codes, medical terminology, anatomy, and health care delivery systems … more
    Molina Healthcare (11/21/25)
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  • Homicide Advocate - Crime Victims Assistance…

    City of New York (New York, NY)
    …support, and advocacy through interactions with law enforcement, the criminal justice system , the medical examiner 's office, and others as necessary. The ... Homicide Detectives. - Assist homicide survivors in navigating the medical Examiner 's office. - Provide immediate emotional support and offering concrete services… more
    City of New York (09/14/25)
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  • Investigator, Coding Special Investigative Unit…

    Molina Healthcare (NY)
    …Tricare, Pharmacy, etc.) + Experience with UNET, Comet, Macess/CSP, or other similar claims processing systems . + Demonstrated ability to use MS Excel/Access ... enforcement or for payment recovery. **KNOWLEDGE/SKILLS/ABILITIES** + Reviews post pay claims with corresponding medical records to determine accuracy of claims… more
    Molina Healthcare (11/20/25)
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