- CVS Health (Albany, NY)
- …day. **Position Summary** Reviews and adjudicates complex, sensitive, and/or specialized claims in accordance with plan processing guidelines. Acts as a subject ... customer service inquiries and problems. **Additional Responsibilities:** Reviews pre-specified claims or claims that exceed specialist adjudication authority… more
- Ross Stores, Inc. (New York, NY)
- …ad hoc client inquires, and compliance/regulatory projects * Project/Process/ Claims Management: Effectively and efficiently develop, maintain and improve ... assessing risk, and making sound business decisions as they relate to claims or projects * Communication, Judgment, and Work Product: Communicate \(verbal,… more
- Guardian Life (New York, NY)
- …partnership with provider contracting, legal, compliance, underwriting, network, and claims . Additionally, this individual will help identify, prioritize, and design ... Insurance to define business requirements for product, network, provider contracts, claims , online and technological capabilities and service. + Drive Go-to-Market… more
- City of New York (New York, NY)
- …professionals and construction contractors; and (iii) contract administration issues including claims analysis, delay claims analysis, review of potential change ... to Alternative Project Delivery, as well as administrative matters involving Comptroller claims and the CDRB, among other types of claim and litigation related… more
- Rochester Regional Health (Rochester, NY)
- …effectively and accurately managing a receivable. Resolve edits to ensure accurate claims are sent to primary and secondary insurances. Research and resolve denials ... payer website, coverage policies and/or phone calls to the payer. Submit corrected claims and appeals. + Process account adjustments and refunds as needed according… more
- City of New York (New York, NY)
- …following: Investigate and assist in the preparation for trial of less serious claims for and against the City. Secures evidence by interviewing interested parties, ... or university and two years of full-time satisfactory experience investigating and/or settling claims for personal injury or property damage or loss; or 3. A… more
- City of New York (New York, NY)
- …obtain prior authorization approvals and claim reimbursement. - Review all claims CPT/ICD-10/HCPCS, payment modifiers in billing software to ensure accuracy ... guidelines.- - Monitor EDI denials in a timely manner. - Prepare and batch claims out to third party payers for reimbursements. - Review clearinghouse acceptance and… more
- CDM Smith (Albany, NY)
- …and maintaining a project risk register. Claim management: Early support for claims and disputes on the project. Identify contractual requirements to maintain and ... prosecute claims , and assist project team in managing to those...identity or gender expression), national origin, age, marital status, disability , veteran status, citizenship status, genetic information or any… more
- City of New York (New York, NY)
- …which consists of five distinct departments: 1) Centralized Data Entry (CDE), 2) Claims & Collections (C&C), 3) Division of Financial Review and Processing (DFRP), ... 4) Office of Liens & Trust (OLT) and 5) Supplemental Nutrition Assistance Program, Claims & Recovery (SNAP-CR). The Office of Revenue is the collection branch of the… more
- City of New York (New York, NY)
- …and operations, DEP is involved in a significant amount of litigation and claims filed with the New York City Comptroller's Office. BLA's staff provide critical ... or university and two years of full-time satisfactory experience investigating and/or settling claims for personal injury or property damage or loss; or 3. A… more