• Analyst, Claims Research

    Molina Healthcare (Yonkers, NY)
    claims projects + Assists with reducing re-work by identifying and remediating claims processing issues + Locate and interpret regulatory and contractual ... standard principles and applicable state specific policies and regulations to identify claims processing errors + Applies claims processing and technical… more
    Molina Healthcare (05/16/25)
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  • Claims Analyst

    CenterLight Health System (NY)
    …+ Validate Diagnosis-Related Group (DRG) grouping and (re)pricing outcomes presented by the claims processing vendor to ensure accuracy. + Attend Joint Operating ... + Proficiency in MS Excel, Word, PowerPoint, and experience using a claims processing system or comparable database software. + Effective oral, written, and… more
    CenterLight Health System (04/26/25)
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  • Claims Service Representative 1/Trainee 1/2

    New York State Civil Service (New York, NY)
    …Representative 2, the incumbent will oversee all aspects of workers compensation claims processing from inception to closing; initially determine the ... NY HELP Yes Agency Insurance Fund, State Title Claims Service Representative 1/Trainee 1/2 Occupational Category Other Professional Careers Salary Grade 18… more
    New York State Civil Service (05/15/25)
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  • Claims Specialist -temp to perm - FlexStaff

    FlexStaff (Bronx, NY)
    …Subrogation conditions - Validates DRG grouping and (re)pricing outcomes presented by the claims processing vendor - Attends JOC meetings with providers as ... by creating and testing compensation grids used for reimbursement and claims processing - Ensures that refund checks are logged and processed, enabling… more
    FlexStaff (05/14/25)
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  • Sr Claims Systems Data Analyst - QNXT

    Molina Healthcare (Buffalo, NY)
    …functionality through project inclusion and documentation review to understand proper claims processing for the applicable solution. Validates data received ... on claims to identify billing issues that will impact claims processing and payment. Monitor new solutions implemented to identify defects in the solution or… more
    Molina Healthcare (05/18/25)
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  • Claims Adjudicator

    Independent Health (Buffalo, NY)
    …certificate and/or college degree preferred. + Six (6) months of medical claims processing /medical billing experience, customer service experience preferably in ... a culture that fosters growth, innovation and collaboration. **Overview** The Claims Adjudicator is responsible for adjudicating and adjusting medical and/or dental… more
    Independent Health (05/14/25)
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  • Claims Processor

    Stony Brook University (Commack, NY)
    …experience working in a medical and/or office setting. Previous medical claims processing experience. **Preferred Qualifications:** Medical coding certification. ... Claims Processor **Required Qualifications (as evidenced on attached...minimal supervision. S/he will be responsible for assisting the Claims Manager with the following duties: + Verifying accuracy,… more
    Stony Brook University (05/21/25)
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  • Manager, Long Term Disability Claims

    Lincoln Financial (Albany, NY)
    …and concerns. * Meeting all established quality assurance benchmarks. * Ensuring claims processing is consistent with applicable policies, procedures, and ... Glance** We are excited to bring on a highly motivated Claims Manager to our Long Term Disability Claims Organization! As a Claims Manager, you will provide… more
    Lincoln Financial (05/20/25)
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  • Claims Specialist

    Actalent (Bronx, NY)
    …(COB), Worker's Compensation, No-Fault, and Subrogation conditions. Skills & Qualifications: + Claims processing and analysis. + Medical billing and claims ... handling. + Proficiency in Microsoft Office Suite. + Experience with claims processing systems or comparable database software. + Certified Professional Coder… more
    Actalent (05/19/25)
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  • Claims Specialist Hybrid- FlexStaff (Temp)

    FlexStaff (Bronx, NY)
    …Subrogation conditions + Validates DRG grouping and (re)pricing outcomes presented by the claims processing vendor + Attends JOC meetings with providers as ... by creating and testing compensation grids used for reimbursement and claims processing + Ensures that refund checks are logged and processed, enabling… more
    FlexStaff (05/14/25)
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