- Dal-Tile Corporation (New York, NY)
- …that an employee in this position would be expected to manage. Investigate claims submitted by customers to determine root cause, identify possible solutions, and ... coordinate actions with necessary functions to resolve replacement or remedial claims caused by manufacturing defects, addressing any disputes, and negotiating any… more
- HUB International (Melville, NY)
- …to in-force benefit programs through: + Generate and explain in layman's terms, projected claims , reserves and other key numeric indicators based on prior claims ... history as well as utilization/H&P data. + Provide periodic financial reporting to the client. + Participate collaboratively in ongoing consultation regarding the future financial impact of high-cost claimants. + Utilize state-of-the-art data analytics… more
- Molina Healthcare (Syracuse, NY)
- …Ability to influence across multiple organizational functions - Payment Integrity, Claims , Encounters, Finance, and Actuarial + Proven experience in managing complex ... implement efficient enterprise-wide processes and governance structures that span claims , encounters, clinical, finance and actuarial functions. + Identifies,… more
- Sedgwick (Albany, NY)
- …for this or other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The ... advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. With… more
- Humana (Albany, NY)
- …first** The Encounter Data Management Professional ensures data integrity for claims errors. The Encounter Data Management Professional work assignments are varied ... make an impact** **Required Qualifications** + 1 - 5 years or more of claims processing experience + Minimum of 1 year experience in conducting thorough root cause… more
- Catholic Health Services (Melville, NY)
- …himself/herself in conformity with the CHS Security policies and procedures. Analyze claims data with the goal of identifying and quantifying payment issues and ... preferred. Strong ability to analyze and accurately summarize complex claims data and effectively communicate conclusions. Excellent communication skills.… more
- ConvaTec (Massapequa, NY)
- …prior to submission. + Follows up with insurance companies on unpaid or rejected claims . Resolves issues and resubmits claims . + Reads and interprets insurance ... explanation of benefits. Maintains specialized knowledge in insurance processes and guidelines, including authorizations and limitations. + Investigates insurance claim denials, exceptions, or exclusions. Takes necessary action to resolve claim and payer… more
- Northwell Health (Garden City, NY)
- …Summary: Process new insurance policies, modifications to existing policies, and claims forms. Obtain information from policyholders to verify the accuracy and ... completeness of information on claims forms, applications and related documents, and company records. Update existing policies and company records to reflect changes… more
- Allied Universal (Buffalo, NY)
- Advance Your Career in Insurance Claims with Allied Universal(R) Compliance and Investigation Services. Allied Universal(R) Compliance and Investigation Services is ... **4** **/** **hr** **RESPONSIBILITIES:** + Conduct independent investigations of insurance claims across a range of coverage types, including workers' compensation,… more
- PSEG Long Island (Hicksville, NY)
- …and administration of contracts for various projects including: (a) managing change orders, claims and back charges; + (b) asserting warranty claims ; (c) ... developing methods for assessing contractor performance; and (d) implementing the appropriate processes and controls for protecting and preserving the Company's contractual rights and remedies. + For new contracts, this position will be responsible for… more