- Zurich NA (New York, NY)
- …The Zurich Way of Underwriting Framework within delegated authority levels on highly complex accounts. We focus strongly on our customers and are seeking someone ... Diploma or Equivalent and 10 or more years of experience in the Claims , Underwriting support areaOR + Zurich Certified Insurance Apprentice including an Associate… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …set by regulatory and accreditation entities. Refers appropriate cases to the Medical Director for review. Refer to and work closely with Case Management to address ... and refers potential quality of care and utilization issues to Medical Director . + Utilizes appropriate communication techniques with members and providers to obtain… more
- CSEA (Albany, NY)
- …Supervisor JOB SUMMARY: The Member Solutions Center Supervisor reports directly to the Director of Membership. In partnership with the Director , the Member ... possible for our members.4. Assist the Member Solutions Specialists in resolving complex member issues and handling escalated phone calls; provide regular feedback… more
- Evolent (Albany, NY)
- …health plans and providers to achieve better outcomes for people with most complex and costly health conditions. Working across specialties and primary care, we seek ... most valuable defects. The IQA reports to a associate director or a manager. One or many IQAs may...Knowledge of Medicare, Medicaid, Commercial Plans and understanding on claims workflow, members, providers + A minimum of 1… more
- Molina Healthcare (Syracuse, NY)
- …This role has decision-making accountability for ensuring compliance with complex regulatory requirements, protecting the integrity of enterprise revenue, and ... + Ability to influence across multiple organizational functions - Payment Integrity, Claims , Encounters, Finance, and Actuarial + Proven experience in managing … more
- MTA (New York, NY)
- …108,933 - $ 130,719 HAY POINTS: 451 DEPT/DIV: Information Technology SUPERVISOR: Director , Product Development LOCATION: Various/ 2 Broadway, New York, NY 10004 ... a highly experienced Systems Engineer with relevant experience across claims , insurance, enterprise safety and security systems, occupational health services,… more
- Mount Sinai Health System (New York, NY)
- …**Responsibilities** + Prepares reports as directed by the Assistant Vice President or Director . Does data mining, analyses of underpaid claims and detail report ... credit balance resolution. + Collects, reviews and investigates unpaid claims internally and with established payers + May work...for all people, everywhere, by taking on the most complex health care challenges of our time - discovering… more
- Zurich NA (Albany, NY)
- …into improvements for portfolio management and tiering + Handle the most complex casualty queries and referrals within delegated authority, including approval of ... Diploma or Equivalent and 14 or more years of experience in the Claims or Underwriting Support areaOR + Zurich Certified Insurance Apprentice including an Associate… more
- AECOM (New York, NY)
- …infrastructure consulting firm, partnering with clients to solve the world's most complex challenges and build legacies for future generations. There has never been ... by our regional operational and technical teams and reports to the NYM Director of Architecture. The candidate will also collaborate with the Global Head of… more
- Cardinal Health (Albany, NY)
- …and proactively provides guidance and trainings on policies. Reporting to the Director , Ethics & Compliance, this position supervises and manages audits to determine ... coders, billers and other appropriate staff. This position will also support the Director with transactional audit diligence and integration planning, as well as the… more