- Sedgwick (New York, NY)
- …Executive General Adjuster - Northeast Region **PRIMARY PURPOSE** : To investigate claims internationally of any size or complexity, against insurance or other ... be negotiated. + Attends litigation hearings. + Revises case reserves in assigned claims files to cover probable costs. + Prepares loss experience reports to help… more
- Evolent (Albany, NY)
- …cost and use trends, and estimate Evolent's ability to reduce costs and improve quality . + Develop models to quantify and articulate value of new and existing ... fostering trust, expertise and cooperation. + Extract, manage, and analyze claims and operational data using industry-standard metrics. + Process and validate… more
- Otsuka America Pharmaceutical Inc. (Albany, NY)
- …and guidelines. - Confirms submission documents are accurate, compliant, and high- quality to allow for smooth and expeditious approvals from regulatory authorities. ... department to execute departmental initiatives to improve overall efficiency, quality , and/or output. - Assess and develop innovative ideas...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more
- Otsuka America Pharmaceutical Inc. (Albany, NY)
- …reduction where appropriate. + Collaborate with cross-functional teams including R&D, Quality Assurance, Regulatory Affairs, and Operations to align strategies and ... + Ensure compliance with cGMP regulations and other relevant quality standards + Represent the MSAT function in interactions...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more
- Brighton Health Plan Solutions, LLC (New York, NY)
- …any time with or without notice. Primary Responsibilities + Thorough review of claims and medical documentation. + Prepare cases for clinical review. + Resolve and ... all other correspondence. + Communicate effectively with individuals/teams to ensure high quality and timely expedition of customer requests. + Research and document… more
- Otsuka America Pharmaceutical Inc. (Queens, NY)
- …of regulatory requirements, operational challenges, and the distinct clinical and quality -of-life needs of LTC (Long Term Care) residents. The specialist will ... expert opinions. This information supports healthcare providers in delivering high- quality care and ensures they are informed about the...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more
- MetLife (Oriskany, NY)
- …of MetLife. The customers who call into our call center call to file their claims , or to service their active claims . Call types include callers with disability, ... in a consistent, professional manner while exercising strong verbal, interpersonal and high- quality service skills. Required Qualifications * New hires should live a… more
- Otsuka America Pharmaceutical Inc. (Albany, NY)
- …commitment to collaborative problem solving, sophisticated design, and the creation of quality products are essential. Your team's primary focus is building core ... software architecture, diagrams, design documents + Ensure the performance, quality , and responsiveness of applications + Unit-test code for...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more
- BronxCare Health System (Bronx, NY)
- …and claims activities, support of and participation in Continuous Quality Improvement (CQI) teams, consistent adherence to the specific rules and regulations ... Overview Conduct review of denied claims and audits of registration/insurance verification activities to improve denial rates and enhance revenue. In-service staff… more
- Mount Sinai Health System (New York, NY)
- …knowledge of a health care EMR such as Epic/Clarity, eCW, etc.; a payor claims system such as Facets, Amisys, etc.; or a hospital/provider system such as IDX, ... **Responsibilities** 1. Analyzes data requests using information technology, enrollment, claims , pharmacy, clinical, contract, medical management, financial, administrative and… more