- City of New York (New York, NY)
- …represent the EAO position to support Commissioner Determinations and at dispute and claim hearings with the Office of the Comptroller. The Director will monitor ... Indicators related to audit of payment requisitions and change order processing and recommend adjustments to staffing, audit plans, training, and/or process/system… more
- IQVIA (Bronx, NY)
- …+ Call center experience required (3+ years preferred) + Experience in medical claim processing is a plus + Bi-lingual (English/Spanish) **The pay range ... for this role is $18.00 per hour. To be eligible for this position, you must reside in the same country where the job is located.** **IQVIA** is an Equal Opportunity Employer. We cultivate a diverse corporate culture across the 100+ countries where we operate,… more
- City of New York (New York, NY)
- …to resolve any customer/contractor disputes or complaints. Familiar with Comptroller Claim process or Contractor's insurance follow-up. - Assist in the execution ... may: - Assist in the planning of inspection programs based on data processing reports and management information service projections. - Be required to be on… more
- Coinbase (Albany, NY)
- …experience * Strong knowledge of pull payment processes and experience with fraud claim investigations * A passion for fighting fraud and abuse, and the curiosity ... By submitting your application, you are agreeing to our use and processing of your data as required. For US applicants only, by submitting… more
- CenterWell (Albany, NY)
- …+ 1 - 3 years of grievance and appeals experience + Previous experience processing medical claims + Bilingual (English and Spanish); with the ability to ... English and Spanish + Prior experience with Medicare + Experience with the Claims Administration System (CAS) + Knowledge of medical terminology + Ability to manage… more
- EPAM Systems (New York, NY)
- …into E2E testing strategies + Develop and communicate test strategies covering pharmacy claims processing , NCPDP transactions, and benefit designs + Design test ... leading large, complex, cross-functional teams + Extensive knowledge of pharmacy claims adjudication, NCPDP protocols, formulary management, and benefit design +… more
- Cognizant (Albany, NY)
- …to the Health Plan/Payer. The comprehensive process includes analyzing, reviewing, and processing medical necessity denials for resolution. You will be a valued ... accounts. . Maintain working knowledge of applicable health insurers' internal claims , appeals, and retro-authorization as well as timely filing deadlines and… more
- New York State Civil Service (Watertown, NY)
- …and manage all aspects of the Permit Unit related to reviewing and processing Highway Work Permits. * Oversee the traffic signal unit, including oversight of ... program to gather data for FOIL requests and small claims * * Capital contract ADP Plan reviews and...Regional facilities coordinator. * * Supervise accident damage recovery claims engineer. * * Attend RSMT meetings and track… more
- Capgemini (New York, NY)
- …APIs and middleware Deep understanding of insurance workflows such as underwriting claims processing and customer onboarding Familiarity with cloud based AEM ... Ensure integration with core insurance systems such as policy administration claims billing and CRM platforms Establish development standards reusable components and… more
- Capgemini (New York, NY)
- …Experience in managing agile delivery for insurance platforms such as policy administration claims processing and customer portals. + Proficiency in agile tools ... goals. + Support agile adoption across insurance programs including underwriting claims and policy servicing. + Ensure compliance with insurance regulatory… more
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