- Travelers Insurance Company (New York, NY)
- …evaluating, reserving, negotiating and resolving assigned serious and complex Specialty claims . Provides quality claim handling throughout the claim life cycle ... **What Will You Do?** + Directly handle assigned severe claims . + Full damage value for average claim (without...addition, our mental health program provides access to free professional counseling services, health coaching and other resources to… 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 ... processes performed by a professional staff. Handles complex insurance and contractual coverage issues,...complex and high exposure bodily injury and property damage claims . **Maintain an active inventory of claims ,… more
- Sedgwick (Albany, NY)
- …Clinical Specialist **PRIMARY PURPOSE** : Performs standard clinical evaluations on claims that require additional review based on medical condition, client ... and RESPONSIBILITIES** + Performs standard clinical reviews of referred medical claims based on client requirements to ensure accurate and sufficient information… more
- Highmark Health (Albany, NY)
- …configuring, rolling out, and supporting the Epic Resolute Professional Billing application. Responsibilities include business/systems analysis, requirements ... Epic modules. **Preferred** + 2+ years of Healthcare Revenue Cycle experience ( Claims , Patient Access, Billing) + Epic Certification in Resolute Professional … more
- Evolent (Albany, NY)
- …CPT Codes, RVUs, bundled payments, etc. + Working knowledge of healthcare claims ; specifically, differences between institutional vs professional billing and ... + Lead in-depth analyses of healthcare data - including authorizations, claims , membership, and clinical outcomes to identify cost drivers, utilization patterns,… more
- University of Rochester (Rochester, NY)
- …judgment within department guidelines, the position is responsible for managing professional hospital accounts. Activities performed will focus on resolving balances ... independent decisions as to the processes necessary to collect denied insurance claims , no response accounts, and will investigate resolving billing issues. Maintain… more
- MVP Health Care (Schenectady, NY)
- …thinking and continuous improvement. To achieve this, we're looking for a ** Professional , Quality Analyst** to join #TeamMVP. This is the opportunity for you ... quality data highly preferred + Subject matter expertise in healthcare data- claims , coding, HIE's etc. Experience with quality metrics, (NCQA HEDIS and NYS… more
- Travelers Insurance Company (Melville, NY)
- …resolving assigned Auto and Homeowner related Bodily Injury and Property Damage claims . Provides quality claim handling throughout the claim life cycle (customer ... not manage staff. **What Will You Do?** + Directly handles assigned severe claims . + Provides quality customer service and ensures file quality and timely coverage… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …policies and procedures and related health plan functions such as member services, claims , and the referral process. As well as functions related to legislative and ... case for clinical staff. + Navigates and utilizes corporate applications; core claims and membership system, intranet and related links to provide support to… more
- Whitsons Culinary Group (Islandia, NY)
- …Risk Manager also leads the end-to-end oversight of workers' compensation claims , supporting our employees through clear and empathetic communication, coordinating ... return-to-work programs, and ensuring fair, timely resolution of claims . By analyzing data, monitoring industry and legislative changes, and partnering closely with… more
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