- 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...MUST be 18 years of age or older (21+ preferred ). + MUST have a registered and insured vehicle… more
- CVS Health (Albany, NY)
- …States. **Position Summary** We are seeking an experienced Senior Healthcare Fraud Investigator to join our Special Investigations Unit (Aetna SIU), dedicated to a ... abuse. + Conduct Investigations to prevent payment of suspect or fraudulent claims submitted by insured's, providers, claimants, and customers. + Research and… 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
- 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 ... compliance risks. **Qualifications** Education Requirements ? HS/GED; Bachelors strongly preferred . Additional experience needed in addition to ?experience requirements?… more
- New York State Civil Service (Buffalo, NY)
- …of relevant information technology, including but not limited to the Investigator Mobile Application, IC2, CIS, and Insurance Compliance Investigation Maintenance; ... Compensation Law as relates to enforcement unit procedures and related claims processes. Stay abreast of enforcement-related Workers' Compensation Board program… 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 ... 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)
- …required. Familiarity with CPT and ICD (coding and CCI edits) + Electronic claims processing preferred . **Responsibilities** 1. Follows up on submitted claims ... **Job Description** Responsible for ensuring unpaid and partially paid claims are resolved in an efficient and timely manner. Resolves EOB discrepancies and… more
- Otsuka America Pharmaceutical Inc. (Albany, NY)
- …generation of medical evidence, (eg, observational studies, registries, and investigator -initiated studies (IISs) / investigator -initiated trials (IITs)) + Manage ... field required + Advanced degree (MS, MPH, PharmD, PhD) preferred + Minimum of 5 years in evidence generation...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more
- Mount Sinai Health System (New York, NY)
- …Receivable, Charge Entry, Edits and Payment Posting. This individual facilitates claims processing and payments services rendered by physicians and assists with ... analysis and problem resolution to ensure accurate and timely payment of claims and collection. The Specialist works directly with the Department Administrator.… more