• Diagnosis Related Group Clinical Validation…

    Elevance Health (Latham, NY)
    …applicable state(s). + Requires a minimum of 10 years of experience in claims auditing, quality assurance, or clinical documentation improvement, and a minimum ... and DRGs billed and reimbursed. Specializes in review of Diagnosis Related Group (DRG) paid claims . **How you will make an impact:** + Analyzes and audits claims more
    Elevance Health (08/09/25)
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  • Director, Operational Oversight (Medicare/Duals)…

    Molina Healthcare (Albany, NY)
    …and you keep complaint data synchronized across appeals & grievances, enrollment, claims , pharmacy, and quality functions. You surface systemic issues, steer ... grievances, and member communications. * Exposure to downstream domains: Enrollment, Claims , Pharmacy/PDE, Network, Stars quality metrics. * Proven record… more
    Molina Healthcare (07/29/25)
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  • Senior Claims Management Counsel

    Northwell Health (Great Neck, NY)
    **Req Number** 164495 Job Description Participates in the management of a Claims Management Program. Prioritizes and monitors claims filed, evaluates insurance ... defense counsel. Job Responsibility *Orients, mentors and acts as a resource to claims team members. *Develops programs and presentations to educate staff members on… more
    Northwell Health (08/08/25)
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  • Senior Claims Specialist

    Axis (New York, NY)
    …request for candidates taking part in the selection process. **Job Description: Senior Claims Specialist** AXIS is seeking a Senior Claims Specialist to join ... Claims team reporting to the Manager of Casualty Claims . This position requires senior claims management...of internal Severity and Coverage resources. + Compliance & Quality Assurance - Comply with best practices measured by… more
    Axis (06/25/25)
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  • Claims Specialist Sr , Professional…

    Sedgwick (Albany, NY)
    …Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Specialist Sr , Professional Liability (MEDMAL) **PRIMARY PURPOSE** : To analyze ... complex or technically difficult medical malpractice claims ; to provide resolution of highly complex nature and/or severe injury claims ; to coordinate case… more
    Sedgwick (08/14/25)
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  • Senior Claims Representative - REMOTE

    Ryder System (Albany, NY)
    …(http://ryder.com/job-applicant-privacy-policy) ._ **Job Description** : **Summary** The Senior Claims Representative handles complex and mid-to-high exposure bodily ... injury and property damage claims under Ryder's self-administered liability program. This position investigates...based on documented file developments + Completes detailed and quality internal reports + Routinely interacts with primary and… more
    Ryder System (08/14/25)
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  • Claims Team Manager, Workers Comp

    Zurich NA (Albany, NY)
    Claims Team Manager, Workers Comp 126104 At Zurich North America Claims we acknowledge that work life-balance and flexibility are a priority when it comes to ... your next career move. Designed with our employees' needs in mind, the ZNA Claims hybrid work model emphasizes flexibility, allowing claims employees to conduct… more
    Zurich NA (08/08/25)
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  • Director of Claims Financial Lines, Cyber…

    The Hartford (New York, NY)
    …partners during claims audits and treaty renewals. + Ensure high quality claim handling with respect to coverage, liability and damages analysis, litigation ... Dir Claims FL - CV06EE We're determined to make a...to the Assistant Vice President of Errors & Omissions Claims , the Technology and Cyber Director will lead a … more
    The Hartford (07/30/25)
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  • Claims Processor

    City of New York (New York, NY)
    …in service to all of them. It's an opportunity to provide critical support, quality customer service, and help protect the future of New York City for generations ... Department of Citywide Administrative Services (DCAS) seeks to hire a Claims Processor within Human Capital's Unemployment Insurance Unit. The Unemployment Insurance… more
    City of New York (07/26/25)
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  • Claims Business Analyst

    Axis (New York, NY)
    …available upon request for candidates taking part in the selection process. ** Claims Business Analyst** **How does this role contribute to our collective success?** ... We are seeking a Claims Business Analyst to join our Business Technology Services...+ Analytical and detail-oriented with a focus on delivering high- quality outcomes. + Strong facilitation skills and the ability… more
    Axis (07/22/25)
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