- City of New York (New York, NY)
- …employees serving in a permanent (not provisional) Civil Service title of Claim Specialist . To be considered for this position, PLEASE CLEARLY INDICATE YOUR CURRENT ... Adjustment (BLA), negotiates and approves all monetary settlement of claims and lawsuits involving the City of New York....Set up No-fault claim files which includes issuing and processing NF2 application, confirming the City's involvement on the… more
- Sedgwick (Albany, NY)
- …a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Specialist Sr - Commercial Coverage Specialist **PRIMARY PURPOSE** ... **:** To analyze complex or technically difficult medical malpractice claims ; to provide resolution of highly complex nature and/or severe injury claims ; to… more
- Axis (New York, NY)
- …part in the selection process. **About the Team** AXIS is hiring a Senior Claims Specialist , E&S Property, to support its expanding presence in North America's ... coverage, liability, and settlement value. + Leading initiatives to enhance claims processing efficiency and accuracy within the team. + Collaborating with legal… more
- Northwell Health (New York, NY)
- **Req Number** 166205 Flexstaff is hiring a CLAIMS SPECIALIST on a fulltime Temporary basis. (Coding/ Claims experience needed, Data Analysis a plus) The ... Claims Specialist will support department operations related to provider communication,...Validates DRG grouping and (re)pricing outcomes presented by the claims processing vendor. Attends JOC meetings with… more
- Molina Healthcare (Albany, NY)
- …communicate written and verbal + Knowledge of verifying documentation related to updates/changes within claims processing system . + Experience using claims ... incorrect coding, abuse and fraudulent billing practices, waste, overpayments, and processing errors of claims . ( _Use for claims specific positions only_ )… more
- CVS Health (Albany, NY)
- …Claim Benefit Specialist reviews and adjudicates complex, sensitive, and/or specialized claims in accordance with plan processing guidelines. They will act ... service inquiries and problems. **Key Responsibilities** + Reviews pre-specified claims or claims that exceed specialist... claims or claims that exceed specialist adjudication authority or processing expertise. +… more
- FlexStaff (Bronx, NY)
- **Req Number** 154447 FlexStaff is seeking a Claims Specialist to support department operations related to provider communication, pending claim review, ... conditions + Validates DRG grouping and (re)pricing outcomes presented by the claims processing vendor + Attends JOC meetings with providers as appropriate to… more
- CVS Health (Albany, NY)
- …Reviews pre-specified claims or claims that exceed specialist adjudication authority or processing expertise. - Applies medical necessity ... every day. **Position Summary** Reviews and adjudicates complex, sensitive, and/or specialized claims in accordance with plan processing guidelines. Acts as a… more
- New York State Civil Service (Melville, NY)
- …include, but are not limited to:*Oversee all aspects of workers' compensation claims processing from inception to closing.*Initially determine the compensability ... Law. Examples of eligible titles include but are not limited to: Administrative Specialist Trainee 2, Claims Services Representative DB Trainee 2, Underwriter… more
- City of New York (New York, NY)
- …Assistant Manager who will: - Directly and indirectly supervise staff (PAAII, PAAI, Eligibility Specialist II) involved in Claims processing . - Monitor and ... Within AO, exists Office of Revenue that houses SNAP-CR. They establish SNAP claims for the agency according to the Federal SNAP guidelines to recover inaccurate… more