- University of Rochester (Rochester, NY)
- …Access Representative III (PAR) is responsible for the overall financial management and coordination for home infusion referrals including removal of barriers ... to acquire necessary information and assembly of documentation necessary to submit claims to the patient's insurance for approval including prior authorization and… more
- City of New York (New York, NY)
- …materials; managing all grant-related activities including expenditures; deliverables, fiscal claims , evaluations, and reporting; and providing guidance to partner ... providing progress reports to the State; handling program audits; and ensuring participating agency claims are paid in a timely manner. The Director will also act as… more
- Zurich NA (Albany, NY)
- …based in any of our Zurich Offices. Responsibilities include: + Portfolio management for assigned line of business + Monitor product and pricing/rating performance. ... technical training + Provide input into improvements for portfolio management and tiering + Handle the most complex casualty...and 14 or more years of experience in the Claims or Underwriting Support areaOR + Zurich Certified Insurance… more
- Nestle (New York, NY)
- …Review and update policies and procedures as necessary related to the Safety Management program. + Ensure sites maintain continuous "audit ready" state of compliance ... as all applicable external regulatory requirements. + Initiates WC Claims to insurance provider. + Ensure all locations have... as required. + Partners with Human Resources and Management on Modified Duty review. + Follow up with… more
- HNTB (New York, NY)
- …Communicates status of schedule and key risk areas to members of project management team. + Performs schedule risk analysis, including quantitative risk analysis. + ... alternate sequencing in order to mitigate or avoid schedule delays. + Performs claims related analysis using contractor claims , delay cost estimates, time… more
- Molina Healthcare (Albany, NY)
- …of a formal appeal being submitted. + Independently re-evaluates medical claims and associated records by applying advanced clinical knowledge, knowledge of ... Officer on denial decisions. + Resolves escalated complaints regarding Utilization Management and Long-Term Services & Supports issues. + Identifies and reports… more
- Pfizer (New York, NY)
- …patient care, closing quality gaps, and addressing population health management + Compliantly integrate understanding of clinical, Health Information Technology ... be in any of the following: + Clinical, formulary, and/or other management experience + Managed Care, pharmaceutical industry, and/or Quality Improvement + Data… more
- Defense Contract Management Agency (Syracuse, NY)
- …study must be in quality assurance, statistics, mathematics, production management , industrial management , computer science, engineering, engineering technology, ... (unofficial are acceptable at the time of application) to support your educational claims . Or, if you are using education to qualify in lieu of specialized… more
- Independent Health (Buffalo, NY)
- …testing to assess impacts on pricing outcomes. + Establish and implement claims review processes to support risk adjustment. Analyze data and provide strategic ... to align risk adjustment decisions with organizational goals. + Analyze healthcare claims data, enrollment data, and other relevant information to identify trends… more
- Hannaford (Kingston, NY)
- …forms if needed. * Maintain organized filing system for invoices, manual insurance claims , daily reports, etc.. in accordance with Standard Practice Manual and state ... service skills. Strong data entry and basic mathematic skills. Effective time management skills and sense of urgency. Effective interpersonal skills and ability to… more