- Sedgwick (Albany, NY)
- …United States. **PRIMARY PURPOSE** : Performs standard clinical evaluations on claims that require additional review based on medical condition, client requirement, ... FUNCTIONS and RESPONSIBILITIES** + Consults on and evaluates complex claims to determine objective, quantifiable, medically supported work restrictions/accommodations.… more
- Ithaca City School District (Ithaca, NY)
- …lunch applications, account receivables, verify accounts payables, track attendance and audit timesheets, inventory, submit claims for reimbursement, prepare ... various reports and other duties as assigned. Location(s): Ithaca High School Anticipated Start Date: 2/24/2025 Posting Dates: 1/22/2025 - until filled Number of Vacancies: 1 Hours per Week: 38.50 (Schedule will be determined by building.) Civil Service… more
- Independent Health (Buffalo, NY)
- …coding and documentation. The incumbent is also responsible for assisting in the claims review, medical record capture and review, and identification of the one best ... record to verify CMS HCC submission as assigned per CMS RADV audit specifications. The Analyst is going to assist the manager in training coding integrity associates… more
- YAI (Manhattan, NY)
- …Functions & Responsibilities + Reviews and interprets patient eligibility and claims data from various sources (explanation of benefits, remittance statements, ... collections reports, etc.) to assess the correctness of claims submitted for processing, identifying and communicating discrepancies, issues and/or missing… more
- Axis (New York, NY)
- …Accuracy and Data Integrity** + Verifies the accuracy of reported premiums, claims , and reserves. + Identifies discrepancies in ceded premium calculations or loss ... with treaty terms and regulatory requirements. + Review reinsurance premiums, claims , and recoverable for accuracy and completeness. + Collaborate with underwriters,… more
- New York State Civil Service (Albany, NY)
- …Building - Core 1 City Albany State NY Zip Code 12239 Duties Description Audit and Risk Management is responsible for administering a comprehensive audit and ... play an important role in ensuring the success of these modernization efforts. Audit and Risk Management performs audits of both the Department's operations and the… more
- City of New York (New York, NY)
- …Utilize standard audit procedures examine records and documents that support claims submitted to Medicaid for reimbursement for goods or services rendered to ... complies with all statutory, regulatory, and contractual standards. The Office of Audit Services (OAS) is responsible for the assessment of operational risk within… more
- City of New York (New York, NY)
- …to oversee the Senior Auditors' performance of the following tasks: - Reviewing draft audit reports of CBOs prepared by DYCD's contracted independent audit firms ... CPA firms. - Evaluating CBO's proposed corrective action plans prepared to address audit findings. - Following up on corrective action plans accepted by DYCD to… more
- City of New York (New York, NY)
- …of Homeless Services (DHS). AO maintains the operation of the Office of Audit Services (OAS) and Office of Quality Assurance (OQA), Special Investigations Division ... Trusts is responsible for the settlement of liens and claims for recoupment of money expended in Medicaid and...the Estates Unit represents DSS and asserts liens and claims against recipients' assets for the recovery of benefits… 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