- KPH Healthcare Services, Inc. (Gouverneur, NY)
- …Expected to partner with necessary entities in order to effectively input, audit and adjust within the adjudication platform. **Job Summary:** Perform day-to-day ... resources within and external to ProAct as needed in order to input, audit , and adjust data within the adjudication platform. **Responsibilities** + Perform benefit… more
- Axis (New York, NY)
- …of key internal stakeholders (legal, finance, reinsurance, product, underwriting, operations, claims , etc.). * Lead engagement with MGA/program and key external ... and Underwriting Guidelines and keep them current. * Manage Underwriting File Audit and Underwriting File Inspection process, templates, and standards per the… more
- Grant Thornton (Melville, NY)
- …derivative models, equity instruments in complex capital structures, and contingent claims , utilizing advanced statistical and financial concepts such as stochastic ... a licensed, certified public accounting (CPA) firm that provides audit and assurance services ― and Grant Thornton Advisors...tax practice, as well as independent American and Irish audit practices. With $2.7 billion in revenues and more… more
- STELLAR SERVICES (Tarrytown, NY)
- …minutes + Prepare drafts of official correspondence and presentations + Audit Design-Builder's project records (materials/quality) to monitor compliance + Analyze, ... summarize and organize data from audit , verification and oversight activities + Perform material/quantity take...Support Project staff with management of disputes and potential claims + Interpret and explain plans and contract terms,… more
- Humana (Albany, NY)
- …operational goals, including regulatory compliance requirements + Promotes and builds an " Audit Ready Every Day" culture + Further simplifies and improves processes ... operational efficiencies + Collaborates with upstream business partners such as Claims , Clinical Guidance, and the Provider Network to identify opportunities and… more
- City of New York (New York, NY)
- …bureau manages the Unemployment Insurance (UI) unit, which minimizes UI costs, verifies UI claims made by former employees of all mayoral city agencies and a select ... programs and assisting City agencies in an oversight and audit function. These programs include the NYC Employee Blood...which is responsible for minimizing UI costs, verifying UI claims made by former employees of all mayoral city… more
- Molina Healthcare (Syracuse, NY)
- …of a formal appeal being submitted. + Independently re-evaluates medical claims and associated records by applying advanced clinical knowledge, knowledge of ... the specific programs supported by the plan such as Utilization Review, Medical Claims Review, Long Term Service and Support, or other specific program experience as… more
- City of New York (New York, NY)
- …of Homeless Services (DHS). DSS-AO maintains the operation of the Office of Audit Services (OAS) and Office of Quality Assurance (OQA), Office of Accountability ... and/or systems. - Design, test, and implement the process to evaluate claims for skimming reimbursement in a batch, data-driven manner, with 100% accuracy… more
- CUNY (Bronx, NY)
- …accounts and in performing reconciliations. - As instructed, examines invoices, claims , vouchers, etc.; verifies documents for accuracy by reviewing supporting data ... and records and assists in audit functions. - As authorized, receives remittances and payments;...issues pertinent receipts. - Assists in processing invoices, vouchers, claims , statements, bills, etc. - Perform various calculations and… more
- Ankura (New York, NY)
- …Life Sciences sector in matters relating to compliance with the federal False Claims Act; Anti-Kickback Statute; Food Drug and Cosmetic Act; Department of Justice ... team of industry experts with backgrounds in compliance, regulatory, legal, audit , operations, nursing, pharmacy, medical science, economics, accounting, and data… more