- Molina Healthcare (Rochester, NY)
- …Contracted Provider disputes and appeals to ensure adherence with Molina claims processing standards and provider contractual agreements. Includes responsibility ... from start to finish of the claim disputes to include intake, processing , decisioning,...IPA. + 2 years supervisory/management experience with appeals/grievance and/or claims processing within a managed care setting.… more
- Sedgwick (Albany, NY)
- … by investigating and gathering information to determine the exposure on the claim ; manages claims through well-developed action plans to an appropriate and ... including strategic vendor partnerships to reduce overall cost of claims for our clients. + Manages claim ...directions in a professional and timely manner. + Communicates claim activity and processing with the claimant… more
- Independent Health (Buffalo, NY)
- …certificate and/or college degree preferred. + Six (6) months of medical claims processing /medical billing experience, customer service experience preferably in ... + Identify and communicate process opportunities or improvements. + Prioritize and manage claim processing workload in an efficient manner. + Effective written,… more
- CVS Health (Amherst, NY)
- …stop loss carrier. **Required Qualifications** *Minimum of 1 year of experience in healthcare claims processing *Minimum of 2 years of experience with the suite ... challenging role provides exposure to virtually all aspects of healthcare claims administration, from reinsurance/stop loss, data analytics, provider and broker… more
- Axis (New York, NY)
- …training, and retaining top talent and developing appropriate succession plans + Reviewing, processing , and assigning new D&O claims to adjusters, and meeting ... Description** AXIS is seeking a Head of Management Liability Claims - D&O to join our North America ...the efficient workflow and timely claim service goals for the AXIS D&O team +… more
- Cognizant (Albany, NY)
- …Monday to Friday 8am - 4:30pm ET **Experience:** A minimum of 1 years claims processing is required. **Travel:** None required **About the role:** As ... * Be Responsible for reviewing the data in the claim processing system and comparing with corresponding...to be considered:** * A minimum of 1 year claims processing is required. * Knowledge of… more
- Sedgwick (New York, NY)
- …. + Negotiating settlement of claims within designated authority. + Communicating claim activity and processing with the claimant and the client. + Reporting ... growth, and inclusion. **ESSENTIAL RESPONSIBILITIES MAY INCLUDE** + Analyzing and processing claims through well-developed action plans to an appropriate… more
- M&T Bank (Getzville, NY)
- …reports outlining workflow and processing needed. + Understand difference between the claim types: Short Sales, Foreclosure Claims , Third Party Claims , ... moving the loan to the next phase of the Claim process. + Review claims completed by...**Education and Experience Preferred:** 5 years' Default experience. Full processing knowledge of all disposition types. Knowledge of M&T… more
- New York State Civil Service (Endicott, NY)
- …Representative 2, the incumbent will oversee all aspects of workers' compensation claims processing from inception to closing; initially determine the ... NY HELP Yes Agency Insurance Fund, State Title Claims Service Representative 1/Trainee 1/2 - NY HELPS...with case analysis over the anticipated life of the claim ; recommend cases for appeal to WCB; negotiate and/or… more
- Sedgwick (Albany, NY)
- …FUNCTIONS and RESPONSIBILITIES** + Processes complex auto commercial and personal line claims , including bodily injury and ensures claim files are properly ... and risk transfer opportunities; secures and disposes of salvage. + Communicates claim action/ processing with insured, client, and agent or broker when… more