• Operation Supervisor

    City of New York (New York, NY)
    …of Clerical Associates, Eligibility Specialist, and Principal Administrative Associates involved in claim review and processing . - Assign, evaluate and review ... - Liaise with the Social Security Administration on any issues related to the claims or the use of the Government Service Online (GSO) application. Salary Range:… more
    City of New York (08/28/25)
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  • HR Benefits Specialist

    Racker (Ithaca, NY)
    …Generates reports to track utilization data and trends. + Processes Workers' Comp claims and follow up for injured employees. Tracks trends and generates reports for ... with new-hire orientations - to include providing benefits information and processing clearances. + Performs quality checks of benefits-related data, including PPACA… more
    Racker (08/21/25)
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  • Director, Appeals & Grievances (Remote)

    Molina Healthcare (Buffalo, NY)
    …appeals experience. **Required Experience** * 7 years experience in healthcare claims review and/or member appeals and grievance processing /resolution, including ... Medicare standards and requirements related to non-contracted provider dispute/appeals processing . * Establishes member and non-contracted provider grievance/dispute and… more
    Molina Healthcare (09/26/25)
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  • Medical Investigator I/II

    Excellus BlueCross BlueShield (Rochester, NY)
    …Medicaid, CPT, HCPCS, ICD10, DRG, APC, RBRVS, etc.). + Extensive experience with claims processing systems, claims flow, adjudication process, system edits ... in a clear and concise manner. + Analyzes proactive detection reports and claims data to identify red flags/aberrant billing patterns. + Manages cases as assigned,… more
    Excellus BlueCross BlueShield (09/17/25)
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  • Associate Director, MSAT, Downstream Drug…

    Otsuka America Pharmaceutical Inc. (Albany, NY)
    …as the primary technical subject matter expert (SME) for downstream processing (chromatography, TFF/UFDF, viral clearance/filtration, etc.). + Lead and manage the ... regulatory submissions (IND, BLA, MAA, etc.) related to downstream processing . + Collaborate closely with Upstream MSAT, Validation MSAT,...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more
    Otsuka America Pharmaceutical Inc. (07/18/25)
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  • Senior Eligibility Consultant

    CVS Health (Amherst, NY)
    …and timely policy and eligibility data utilizing administration systems for claim payment purposes and product production ensuring services and products meet ... issues + Partner directly with clients, vendors, internal teams, and/or local claim operation to resolve problems and achieve positive outcomes + Anticipate and… more
    CVS Health (09/02/25)
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  • Finance Operations Coordinator

    Touro University (Valhalla, NY)
    …orders, retrofit orders (check requests), blanket orders, and employee expense claim reimbursements. Additionally, manage the processing of honoraria payments ... Department Administrators (CDA) in managing the clinical department's budget, processing personnel actions, overseeing various financial and operational tasks, and… more
    Touro University (08/28/25)
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  • (USA) Asset Protection Operations Coach

    Walmart (Lockport, NY)
    …by ensuring proper policies and procedures are followed Ensures the timely processing of claims forexample damaged defective returned liquidated items and ... Manages facilitylevel training and execution of asset protection safety and claims and receiving procedures by reviewing the application of policiesprocedures… more
    Walmart (09/30/25)
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  • Administrative Assistant

    Transdev (Hillburn, NY)
    …Provide regular reports to local management staff of safety department efforts, claims status, training efforts, accident history, Workers' Compensation claims ... tracking of safety reports. + Assist the Safety Manager in working with corporate claims staff to ensure that all liability and Workers' Compensation claims are… more
    Transdev (09/05/25)
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  • Customer Care Representative

    CDPHP (Latham, NY)
    …+ Demonstrated ability to determine, analyze and solve problems related to benefits, claims processing , claims and benefit appeals/complaints, enrollment and ... volume call center preferred. + A background in health insurance claims and appeals processing is preferred. + Experience with a documentation system to track… more
    CDPHP (10/03/25)
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