- City of New York (New York, NY)
- …compliance with contract terms and conditions, and to identify FWA when present. Audit managers in this unit also oversee claims analysis at the ... paying attention to the long-term challenges we face together. The Audit Bureau conducts informative and meaningful audits, independent assessments, and objective… more
- Molina Healthcare (Yonkers, NY)
- …and executing operational initiatives tied to Payment Integrity (PI) and provider claims accuracy. The individual will be relied upon to make independent, informed ... + Manages Scorable Action Items (SAIs) related to pre-pay editing, post-pay audit , and overpayment recovery initiatives to ensure Health Plan SAI targets are… more
- MTA (New York, NY)
- …reduce the MTA's cost of risk through risk analysis and transfer, claims management practices, captive financial planning, insurance program placement, and other ... handling All Agency Fiduciary, Fidelity, and agency property insurance claims ( Claims valued over $100 million are...for departmental matters. + Liaise with the MTA's Internal Audit department with regard to the risk management function.… more
- Highmark Health (Albany, NY)
- …supervisory direction and oversight for all enrollment, premium billing, claims and/or customer service telephone and written correspondence inquiries (routine, ... training and mentor programs, and assists to provide interview/hiring and audit support when needed. **ESSENTIAL RESPONSIBILITIES** + Supervises the daily operations… more
- Highmark Health (Albany, NY)
- …OVERVIEW:** Performs all related internal, concurrent, prospective and retrospective coding audit activities. Reviews medical records to determine data quality and ... identified in the audits compliant with regulatory requirements. Provides written audit guidance. Participates with management in the assessment of external … more
- WMCHealth (Valhalla, NY)
- …up and maintained. + Software & Data Management + Maintain, test, and audit split-billing software and associated data feeds, ensuring accuracy and compliance. + ... Develop and refine claims qualification logic and data feeds for contract pharmacy...& Compliance Oversight + Develop and maintain a 340B audit compliance program, executing self-audits and implementing corrective action… more
- Lactalis American Group Inc. (Buffalo, NY)
- …Lactalis EHS to manage LAG's Business Continuity Assurance Program and Plant Audit program. Ensure site preparedness for Business Continuity and Plant Audit ... Provides updates to LUSA and Groupe Lactalis EHS leaders regarding KPI's, audit results and associated action plans. . Prioritize the elimination or reduction… more
- New York State Civil Service (Albany, NY)
- …Description:This position performs assignments to further advance the University's Internal Audit Plan. The audits are conducted in accordance with the International ... and interviews with representatives of the organization being audited to explain audit goals, methodology, and gain access to records.- Conducts the audit… more
- Robert Half Accountemps (White Plains, NY)
- …contract position, you will play a key role in managing promotional claims , investigating account discrepancies, and collaborating with various departments to ensure ... this opportunity is ideal for you. Responsibilities: * Process promotional claims using trade promotion software to ensure accurate matching of bill-back… more
- Family and Children's Association (Mineola, NY)
- …spending for distribution to program personnel. + Maintain information needed for annual audit , including detailed tracking of claims . + Perform other duties as ... The Contract Specialist is responsible for the preparation and submission of claims for funding from various funding sources supporting the operations of Family… more