• Claims Auditor

    Molina Healthcare (Syracuse, NY)
    …of incorrect coding, abuse and fraudulent billing practices, waste, overpayments, and claims processing errors. **Essential Job Duties** + Audits the ... leadership for improvements based on audit results. + Reviews timeliness of claims processing to ensure compliance with contractual and state/federal… more
    Molina Healthcare (12/04/25)
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  • Customer Service Associate - Claims

    MetLife (Oriskany, NY)
    …to the Beneficiary. May also be responsible for setting up new claims , processing incoming mail, and handling expired call-ups. Principal Responsibilities: ... e-mail for communication with agencies/OFEGLI staff and managers. 8. Processing incoming mail for new and existing claims... Processing incoming mail for new and existing claims . 9. Write manual letters and correspondence on FEGLI… more
    MetLife (01/08/26)
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  • Healthcare Malpractice Liability Claims

    Axis (New York, NY)
    …to resolve complex or contentious claims . Leading initiatives to enhance claims processing efficiency and accuracy within the team. Providing expert opinions ... adept at creating and directing the development of training materials relevant to claims processing . Show a commitment to continuous professional development in… more
    Axis (01/06/26)
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  • Benefit and Claims Analyst

    Highmark Health (Albany, NY)
    …the department. + Serve as the liaison between the department and the claims processing departments to facilitate care/case management activities and special ... is a non-clinical resource that coordinates, analyzes, and interprets the benefits and claims processes for clinical teams and serves as a liaison between various… more
    Highmark Health (12/18/25)
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  • Adjudicator, Provider Claims -On the phone

    Molina Healthcare (Buffalo, NY)
    …with the member enrollment, provider information management, benefits configuration and claims processing teams to appropriately address provider claim issues. ... JOB DESCRIPTION Job Summary Provides support for provider claims adjudication activities including responding to providers to address claim issues, and researching,… more
    Molina Healthcare (12/28/25)
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  • Claims Services Representative Trainee 1…

    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 Services Representative Trainee 1 (NY HELPS) Occupational Category Other Professional Careers Salary Grade 14… more
    New York State Civil Service (12/31/25)
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  • Senior Mainframe Developer (Healthcare…

    Cognizant (Albany, NY)
    …them into technical specifications and design documents that support our claims processing workflows, ensuring high-performance, accuracy, and regulatory ... and their associated systems is crucial for understanding the complex claims processing workflow. + Excellent problem-solving abilities with a detail-oriented… more
    Cognizant (01/15/26)
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  • Administrative Support Associate VI - Hospital…

    Albany Medical Center (Albany, NY)
    …Knowledge in billing codes and EDI requirements. Knowledge of electronic claims processing and edits. Excellent decision-making skills, detail oriented, ... + Knowledge in billing codes and EDI requirements. + Knowledge of electronic claims processing and edits. + Excellent decision-making skills, detail oriented,… more
    Albany Medical Center (12/01/25)
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  • Administrative Support Associate VI - Hospital…

    Albany Medical Center (Albany, NY)
    …preferred.Knowledge in billing codes and EDI requirements.Knowledge of electronic claims processing and edits.Excellent decision-making skills, detail oriented, ... and have the ability to submit factual, timely and compelling appeal letters to payors regarding payment variances and denials.Able to communicate effectively and successfully with team members, providers, contractors, payors, and their Leadership group daily.… more
    Albany Medical Center (11/05/25)
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  • Executive Director, Financial Review…

    City of New York (New York, NY)
    …Staff Analyst NM III to function as a(n) Executive Director, Financial Review & Claims Processing who will: - Manage, plan and develop the operational activities ... of DFRP, ICP and SNAP-CR Directors as they administer their specific program areas which are responsible for initiating adverse actions on cash assistance cases due to information obtained via computer matches, sanctioning individuals who fail to cooperate… more
    City of New York (11/05/25)
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