- Ross Stores, Inc. (New York, NY)
- …to promote compliance and mitigate legal exposure, while effectively managing projects/ claims \. The position will report to the Sr\. Director, Employment Law, ... options in order to facilitate business decisions and outcomes\. * Claims management: Effectively and efficiently resolve demand letters and pre\-litigation… more
- CVS Health (Amherst, NY)
- …plan setup, compliance, and seamless processing across Customer Service, Claims , Enrollment, Billing, and Reporting functions. **Key Responsibilities:** + Review, ... reporting. **Required Qualifications:** + 3+ years of experience in healthcare (Quality, Claims , or Plan Build preferred). + Experience with various data systems… more
- City of New York (New York, NY)
- …and accurately compile information to update reporting spreadsheets. - Review violation claims against DOF records, such as Decision and Order statements and STARS ... ensuring responses are given in a timely and accurate manner. - Updating claims resolutions and adjustments in the various program systems. - Maintaining backup… more
- Zurich NA (New York, NY)
- …business operates globally, partnering with leaders across distribution, underwriting, claims , assistance, and shared services to capture requirements, design future ... expertise in at least one functional area (Distribution, Underwriting, Claims , etc.) + Prior experience in a post-merger integration...and come as you are. **Apply today and let's go great places together** ! \#LI-Hybrid EOE Disability /… more
- Guidehouse (New York, NY)
- …this position include: + Responsible for the daily resolution of assigned claims with applicable Revenue Integrity pre-bill edits and/or specific Revenue Integrity ... and associated coding modifiers. + Responsible for daily resolution of assigned claims with Revenue Integrity specific denials in the Guidehouse METRIX℠ system. +… more
- CVS Health (Albany, NY)
- …of about 12-15 colleagues who are responsible for the filing of Stop Loss claims to partner Managing General Underwriter (MGU) and Stop Loss Carriers, follow up, ... peers as necessary **Required Qualifications** * Minimum 5 years operations ( claims , eligibility, plan setup, implementation) or related field; stop loss/reinsurance… more
- City of New York (New York, NY)
- …The role is responsible for overseeing staff responsible for the reconciling of claims payments within the City's self-funded health plan effective January 1, 2026. ... with contractual obligations, regulatory requirements, and internal policies related to health claims and monthly admin fee payments. o Oversee the performance of… 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
- Ellis Medicine (Niskayuna, NY)
- …and related work lists to ensure complete, timely and accurate submission of claims , facilitating the accuracy and completeness of the practice's codes and charges ... for ensuring the financial viability of the assigned practice(s), by producing claims in a timely, accurate and complete manner. Requirements: High School Diploma… more
- Mohawk Valley Health System (New Hartford, NY)
- …of safety, throughout the organization. Responsible for management of pending insurance claims and partnering with brokers and insurers. Core Job Responsibilities + ... current with regulatory requirements related to risk management. + Manages insurance claims in coordination with other members of the legal/compliance department +… more