- Command Investigations (Syracuse, NY)
- …the frontline of the private investigations industry. The primary responsibility of the Investigator is to conduct mobile surveillance of an individual that has an ... on-going insurance claim . Surveillance is conducted in order to document (on video) the individual's daily activities and to ensure that their injuries coincide with… more
- The Robison Group (Brooklyn, NY)
- …such as auto and property theft, fire damages, auto accidents, commercial claims , finding missing persons, courthouse searches, and other investigative tasks. For ... for part-time employment in our Special Investigations Unit (SIU). As an SIU Investigator , you will be joining an incredible team of investigators and industry… more
- EFI Global (Binghamton, NY)
- …and RESPONSIBILITIES** **Accepts assignments from customers for investigation of losses or claims and pursues investigation in accordance with the specific needs of ... the assignment.** **Determines the origin and cause of the loss/ claim under investigation and identifies any potential third-party responsibility for subrogation… more
- CVS Health (Albany, NY)
- …healthcare fraud cases. - Investigates to prevent payment of fraudulent claims committed by insured's, providers, claimants, customer members, etc. - Facilitates ... the recovery of company and customer money lost as a result of fraud matters. - Provides input regarding controls for monitoring fraud related issues within the business units. - Delivers educational programs designed to promote deterrence and detection of… more
- TEKsystems (Queens, NY)
- …of fraud. + Independently review, examine, and decision fraud and merchant dispute claims submitted by members to minimize the credit union's loss exposure, increase ... recovery of stolen funds/assets and meet regulatory requirements. + Monitor member activity and escalated cases using fraud tools to identify potential fraud. Independently determine if transactions are fraudulent and take appropriate action(s). Identify and… more
- New York State Civil Service (Albany, NY)
- NY HELP Yes Agency Insurance Fund, State Title Claims Services Representative 1/Trainee 1/2 - NYHELPS Occupational Category Other Professional Careers Salary Grade ... 12206 Duties Description Under the general supervision of a Claims Services Representative 2 responsibilities include, but are not...with case analysis over the anticipated life of the claim * Recommend cases for appeal to WCB* Negotiate… more
- Mount Sinai Health System (New York, NY)
- …to Directors for potential legal intervention, and assisting in the escalation of claims that may require involvement from insurance carriers or legal entities. The ... cycle management, with a strong understanding of both hospital and professional claims processes. ? Previous experience in a role that involved analyzing contracts,… more
- City of New York (New York, NY)
- Job Description APPLICANTS MUST BE PERMANENT IN THE ASSOCIATE FRAUD INVESTIGATOR CIVIL SERVICE TITLE. The DSS Accountability Office (DSS-AO) is responsible for ... all statutory, regulatory, and contractual standards. The Division of Claims and Collections Division (C&C) is housed within the...levels. C&C is recruiting for (1) one Associate Fraud Investigator II to function as a Group Supervisor, who… more
- Mount Sinai Health System (New York, NY)
- …in relevant RCM modules (eg, Resolute Professional Billing, Hospital Billing, Claims , Contract Management) strongly preferred. + Minimum 7-10 years of progressive ... ensure optimized processes deliver measurable improvements in cost-to-collect, clean claim rates, denial reduction, and cash acceleration. 4. Workflow… 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 ... required. Familiarity with CPT and ICD (coding and CCI edits) + Electronic claims processing preferred. **Responsibilities** 1. Follows up on submitted claims ,… more