- The Cigna Group (New York, NY)
- …of communication with matrix partners including but not limited to, Claims Operations , Medical Management. Credentialing, Legal, Medical Economics, Compliance, ... of the Provider Contracting Team and reports to the Provider Contracting Senior Manager . This role assists in developing the strategic direction and management of… more
- Public Consulting Group (Albany, NY)
- …Group LLC (PCG) is a leading public sector solutions implementation and operations improvement firm that partners with health, education, and human services agencies ... Services + Enhance Health and Public Safety Services + Claims Processing Services and Solutions + Consulting and Advisory...Access and Markets A Test Leader oversees the testing process , developing test strategies and plans, guiding a team… more
- Ryder System (Albany, NY)
- …**SUMMARY** This position supervises adjusters and directly handles claims within Ryder's self-insured, self-administered liability program. Oversees claim-handling ... complex and high exposure bodily injury and property damage claims . **Maintain an active inventory of claims ,...reviews and performance appraisals of assigned staff. Assists Claim Manager with other staff as directed Assists in team… more
- RiseBoro Homecare Inc. (Brooklyn, NY)
- …incidents that require immediate attention in the division + Along with the Operations Manager coordinate and track Certificates of Occupancy, PA permits and ... etc. + Oversee facilities management for the programs + In conjunction with Operations Manager and HR oversee divisional recruitment, including job description… more
- Travelers Insurance Company (Albany, NY)
- …+ 5-10 years experience handling serious injury and complex liability claims preferred (casualty claim operations environment determining coverage, liability, ... reserve, negotiate and resolve the company's most severe and/or complex claims , in multiple jurisdictions, in accordance with Best Practices. Provide quality… more
- Elevance Health (New Hyde Park, NY)
- …for employment, unless an accommodation is granted as required by law. The ** Process Expert II** supports a single operations department by participating in ... ** Process Expert II** _This role will focus on...work. **How you will make an impact:** + Researches operations workflow problems and system irregularities. + Develops tests,… more
- Public Consulting Group (Albany, NY)
- …posted timely. (20%) **Organizational Relationships** **Reports directly to the ASO Project Manager / Sr. Director of Operations ** **Key Qualifications and ... Group LLC (PCG) is a leading public sector solutions implementation and operations improvement firm that partners with health, education, and human services agencies… more
- ASM Global (New York, NY)
- …4. Claims Oversight and Coordination + Lead the organization's claims management process by establishing clear protocols for reporting, documenting, ... and tracking claims related to incidents, property damage, liability, and other...of evolving industry standards and legal developments impacting event operations . 6. Enterprise Risk & Financial Oversight + Implement… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …DRG, APC, RBRVS, etc.). + Extensive experience with claims processing systems, claims flow, adjudication process , system edits and display screens. Level III ... in a clear and concise manner. + Analyzes proactive detection reports and claims data to identify red flags/aberrant billing patterns. + Manages cases as assigned,… more
- CDM Smith (Woodbury, NY)
- …Smith is seeking a Forensic Accounting Specialist with expertise in disaster fraud claims . This role is critical in evaluating and analyzing financial data related ... to disaster-related claims , including property damage, business interruption, and other loss...of the disaster on the applicant's assets, inventory, and operations . * Expert Testimony and Litigation Support: In cases… more