• Coordinator Integrated Disability…

    Catholic Health (Buffalo, NY)
    …licensure preferred EXPERIENCE + Minimum of three (3) to five (5) years of claims management or disability case management work experience required + ... Work Schedule: Days Hours: 8am-4pm Summary: The Coordinator, Integrated Disability Management (IDM) position is responsible for monitoring and aggressively managing … more
    Catholic Health (06/12/25)
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  • Senior Manager, Cost Control

    New York State Civil Service (Albany, NY)
    …Manager, Cost Control takes a lead role in Project Controls functions of claims management , claims negotiation, and litigation support on complex ... fair and reasonable claim resolution. Seek approval from DASNY management and clients on claims settlement.Develop and...approval from DASNY management and clients on claims settlement.Develop and manage internal reports that track the… more
    New York State Civil Service (08/08/25)
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  • Director, Appeals & Grievances (Medicare…

    Molina Healthcare (Rochester, NY)
    …processed in accordance with local Health Plan requirements * Works with Claims , Configuration, Contracting, Provider Data Management , and other business ... claims , COB and DRG/RCC pricing), and IPA. + 2 years supervisory/ management experience with appeals/grievance and/or claims processing within a managed care… more
    Molina Healthcare (07/18/25)
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  • Commercial Claims Processing Associate,…

    MVP Health Care (Rochester, NY)
    …and/or authorization determination. + Meets or exceeds department quality and work management standards for claims adjudication. + Successfully completes a ... improvement. To achieve this, we're looking for a Medical Claims Examiner to join #TeamMVP. This is the opportunity...responsibilities:** + Using a PC /Microsoft Window environment, adjudicates claims with the aid of the Facets and Macess… more
    MVP Health Care (08/13/25)
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  • General & Product Liability Complex Claim Examiner…

    Sedgwick (Rochester, NY)
    …as applicable to line of business preferred. **Experience** Five (5) years of claims management experience or equivalent combination of education and experience ... - Hybrid **PRIMARY PURPOSE** : To analyze complex or technically difficult general liability claims to determine benefits due; to work with high exposure claims more
    Sedgwick (08/08/25)
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  • Claims Auditor

    Centers Plan for Healthy Living (Staten Island, NY)
    …Healthy Living (CPHL) claims . Collaborates with other Health plan departments and Management to ensure claims are processed in accordance with Federal, State ... general supervision. PRIMARY RESPONSIBILITIES: + Conducts monthly audits of CPHL claims utilizing CPHL guidelines, policies and procedures or any other regulatory… more
    Centers Plan for Healthy Living (07/15/25)
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  • Senior Contract Manager

    GE Vernova (Schenectady, NY)
    …to work on-site in Schenectady, NY._** **What will make you stand out:** + Claims management experience + Contract reading and writing experience + Ability to ... including preparation of complex computer graphics presentations + Five plus years claims management experience + Prime contract commercial experience (domestic… more
    GE Vernova (05/20/25)
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  • Contracts Manager

    GE Vernova (Schenectady, NY)
    Management + Ability to handle many complex issues concurrently + 5+ years claims management experience + Construction claims negotiation experience + ... teams remotely located + Contract reading and writing experience + Claims and contract management experience + Excellent English speaking and writing skills +… more
    GE Vernova (05/20/25)
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  • Deputy Director, Risk Assessment and Standards

    MTA (New York, NY)
    …to reduce the MTA's cost of risk through risk analysis and transfer, claims management practices, captive financial planning, insurance program placement, and ... , Risk Assessment and Standards DEPT/DIV: Risk and Insurance Management WORK LOCATION: 2 Broadway FULL/PART-TIME FUL L SALARY...handling All Agency Fiduciary, Fidelity, and agency property insurance claims ( Claims valued over $100 million are… more
    MTA (07/16/25)
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  • Budgets and Contracts Manager

    EAC Network (Garden City, NY)
    …in spending or funding. Timely submission of budget modifications per contract guidelines. Claims Management + Oversee the voucher process for monthly/quarterly ... is a critical role responsible for coordinating the financial management of over 100 programs funded by 60 different...develop plans to address variances. + Process and submit claims requests within 10 business days of the end… more
    EAC Network (08/08/25)
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