- Highmark Health (Albany, NY)
- …for proactive and investigative purposes to comply with internal audit and regulatory requirements. **ESSENTIAL RESPONSIBILITIES** + Performs investigations into ... Credentialing or Medical Review Committee. + Engages in delivery of audit results and overpayment negotiations.Responsible for recovery/ savings of misappropriated… more
- New York State Civil Service (Brooklyn, NY)
- …and maintain working knowledge of tax law as well as Department and Audit Division procedures and policies, including the Code of Conduct, Ethics practices and ... with computer equipment and case materials to various field audit sites, training classes, BCMS conferences, etc.* Represent the...and advocate disputed cases at BCMS conferences and Small Claims Hearings. May participate at hearings as a witness… more
- Constructive Partnerships Unlimited (Staten Island, NY)
- …of Deficiency "SOD's", collaborating with Engineering and CLS management teams. Ensures audit violations are corrected per guidelines provided for physical plant and ... strategies and protocols for handling CPU's life safety program and pre- audit preparation, inclusive of multi-category check lists; conformance with NFPA 25;… more
- M&T Bank (Getzville, NY)
- …might occur in the near future. + Respond to FHA demands, including BCDE Claims , and all other claims besides principal. Provide additional documentation as ... in cases where HUD denied an over-allowable request. + Liaise with Accounting, Claims and Foreclosure groups. + Complete insurance claims for damaged properties… more
- Stony Brook University (East Setauket, NY)
- …Analyst may include the following, but are not limited to:** + Analyze claims and remittance data and present findings to departmental leadership. + Complete ... and trend analyses via spreadsheets, databases and dashboards. + Create audit and reconciliation plans related to: charges, adjustments, expected reimbursement and… more
- Molina Healthcare (Albany, NY)
- …you keep complaint data synchronized across appeals & grievances, enrollment, claims , pharmacy, and quality functions. You surface systemic issues, steer partners ... durable fixes, and convert disciplined CTM management into Stars gains, audit readiness, and measurable member-experience improvements. You'll begin as a senior… more
- AIG (New York, NY)
- …with primary responsibility for operational controlling as it relates to insurance claims disbursements, in close coordination with AIG's global claims function ... of activity. Key Responsibilities: * Driving the timely clearance of insurance claims disbursements through subledgers, ensuring cash is applied properly against … more
- City of New York (New York, NY)
- …DSS complies with all statutory, regulatory, and contractual standards. The Division of Claims and Collections Division (C&C) is housed within the office of Revenue. ... the resources of Medicaid Nursing Home residents through computer bank matches. Claims and Collections also assess the income and resources available to the… more
- FlexStaff (Chappaqua, NY)
- …experience-whether as a Certified Professional Coder or similar professional-to audit and monitor clinical records, ensuring accuracy, completeness, and compliance. ... records are complete, accurate, and support proper billing and coding - Audit anesthesia records focusing on quality, completeness, and correctness of claims… more
- Sunrise Senior Living (Glen Cove, NY)
- …internal business controls. + Process and manage unemployment and worker's compensation claims and update claim activity as necessary. + Clearly communicate and ... completed for each business area. + Assist in providing audit materials and information as requested. + Meet business...to standard operating procedures (SOP). + Maintain and organize audit materials and information for audit review.… more