- OLV Human Services (Lackawanna, NY)
- …standards. A critical part of the role involves evaluating insurance coverage, managing claims processing , and ensuring all aspects of patient care are ... with Finance to ensure patient charts are updated appropriately, if claims are denied/rejected. * Implement and maintain systems for insurance verification,… more
- City of New York (New York, NY)
- …of medical consultation appropriate to the circumstances of the cases. Reviews claims for processing voluntary awards of workers' compensation benefits. Trains ... 5141. Under direct supervision, receives and processes incoming workers' compensation claims . Performs tasks such as the following: Reviews accident reports and… more
- MTA (New York, NY)
- …assists clerical/administrative staff in handling subpoenas, service of process, claims handling/ processing , bankruptcy searches of toll violators, scheduling ... toll revenue, as well as oversees the intake and processing of legal papers served on the TBTA, reviewing...Insurance Management, and other MTA Departments and subsidiaries in claims /litigation by contractors and third parties. + Assists relevant… more
- Travelers Insurance Company (Albany, NY)
- …us most. As a Claim Rep, you will be responsible for managing, evaluating, and processing claims in a timely and accurate manner. In this detail-oriented and ... guides our customers back to stability. At Travelers, our Claims Organization isn't just a department; it's the beating...role, you will work closely with insureds to ensure claims are resolved efficiently while maintaining a high level… more
- Molina Healthcare (Buffalo, NY)
- …of healthcare operations (utilization management, disease management, HEDIS quality measures, claims processing , etc.) + Knowledge of healthcare financial terms ... executive decision-making + Mine and manage information from large data sources. + Analyze claims and other data sources to identify early signs of trends or other… more
- Molina Healthcare (Yonkers, NY)
- …Ensures that provider information is loaded accurately to ensure proper claims processing , outbound reporting and directory processes. **Required ... including accurate and timely maintenance of critical provider information on all claims and provider databases. Synchronizes data within multiple claims systems… more
- Humana (Albany, NY)
- …Operations encompasses critical functions including care coordination, quality measurement, billing, claims processing , and customer service, each essential to ... operational knowledge of core functional areas (care coordination, quality, billing, claims , and customer service). + Collaborate with each Insurance Operations… more
- Colgate-Palmolive (New York, NY)
- …Review benefit payments across sources to prevent overpayments and ensure accurate claims processing . Required Qualifications: + Bachelor's degree in Human ... return-to-work dates with HRBPs. Coordination of Workers' Compensation: + Coordinate Claims and Benefits: Integrate Workers' Compensation claims with concurrent… more
- Centene Corporation (New York, NY)
- …IT resources to implement system efficiencies and configuration enhancements to improve claims processing operations. + Apply Coding Guidelines as described in ... to ICD-10 coding changes and its effect on inpatient claims payment. Chart review will include DRG pre-payment review,...adhered to for the appropriate handling of medical necessity, claims denials, and bundling issues. + Provide regular reports… more
- Capgemini (New York, NY)
- …like Kubernetes Deep knowledge of insurance workflows including policy issuance claims processing and customer servicing Exposure to enterprise integration ... design and development efforts for digital servicing policy management and claims platforms **Key Responsibilities:** Define architecture for responsive secure and… more