- CDM Smith (Buffalo, NY)
- …expertise may be needed throughout the program delivery process. * Supports the claims process by reviewing and validating damage details, scopes of work, and costs ... by providing updates on work status and may evaluate claims and make recommendations to FEMA as to whether...and make recommendations to FEMA as to whether the claim is eligible. Assists with the development of the… more
- Highmark Health (Albany, NY)
- …to several functions, including insurance premium and pricing development, claim trend analysis, experience studies, medical economics, profitability analysis, ... wellness studies, predictive modeling, benefit benchmarking, claim reserving and strategic client support that is both client facing and supportive to Sales… more
- Transdev (Hillburn, NY)
- …safety evaluation logs, files and tracking of safety reports. + Assist the Safety Manager in working with corporate claims staff to ensure that all liability ... recoup on all claims subject to subrogation. + Assist the Safety Manager in the complete and accurate documentation of safety activities and the accurate… more
- City of New York (New York, NY)
- …a permanent Civil Service title of Administrative Engineer, or Administrative Project Manager , or Administrative Construction Project Manager ; or, those who are ... on the civil service list for Administrative Engineer, or Administrative Project Manager , or Administrative Construction Project Manager title. To be considered… more
- Sherwood Lumber Company (Melville, NY)
- …T1 EMPLOYER: Sherwood Lumber Corporation DEPARTMENT: Sales REPORTS TO: Inside Specialty Manager EFFECTIVE DATE: 8/1/2024 SUMMARY: We are seeking a highly motivated ... will be responsible for order entry and associated tasks, Claims and Credits management, and handling phone calls and...tasks. This position reports directly to the Inside Sales Manager (ISM). DUTIES AND RESPONSIBILITIES: + Order Entry and… more
- Mount Sinai Health System (New York, NY)
- …Proficient in these processes to ensure accurate and timely payment of claims and collection, and in analysis and problem resolution. **Qualifications** + Associates ... coder required + Experience in medical billing or health claims , with experience in EPIC & IDX billing systems...16. Mentors less experienced Billing staff and assists Billing Manager /FPA Manager in training new staff. 17.… more
- Elevance Health (New Hyde Park, NY)
- …issues and Provider experience_ **.** _Conducts provider training and education on claim denials due to billing errors and maintains Behavioral Health content on ... process improvement, project coordination in a high-volume managed care operation ( claims , customer service, enrollment and billing); or any combination of education… more
- Elevance Health (New Hyde Park, NY)
- …special projects such as understanding changes in cost and utilization at a claim level + Responsible for educating and making recommendations on changes in expense ... and actuarial software tools. + Experience working with large administrative claims datasets and healthcare cost/utilization metrics. + Ability to apply actuarial… more
- Centene Corporation (New York, NY)
- …structures, premium groups, regions, category-of-service mapping, and encounter vs. financial claim alignment. + **Financial Analysis & Accounting :** + Strong ... MAP, Medicare Advantage, and cost-sharing arrangements. + Knowledge of utilization, claims , member-months, and how they relate to cost reporting. + **Leadership… more
- University of Rochester (Rochester, NY)
- …requiring provider intervention. + Resolves flagged reports to ensure timely submission of claims to payers. + Monitors and ensures worklists are completed in a ... timely manner. + Monitors cash flow, receivables, Hold Bills, Claim Edits, and aging reports, as well as payment and denial worklists. + Performs monthly audits of… more