• Diagnosis Related Group Clinical Validation…

    Elevance Health (Latham, NY)
    …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 ... applicable state(s). + Requires a minimum of 10 years of experience in claims auditing, quality assurance, or clinical documentation improvement, and a minimum of 5… more
    Elevance Health (08/09/25)
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  • Accounts Receivable Specialist Clients- Medical…

    Catholic Health (Buffalo, NY)
    …Cntr Shift: Shift 1 Status: Full Time FTE: 1.066667 Bargaining Unit: Catholic Health Emmaus Exempt from Overtime: Exempt: No Work Schedule: Days Hours: flexible ... denials on a timely basis + Review of all claims for accuracy + Review and identify errors or...and other publications. + Follow up on any unpaid/outstanding/denied claims within the payers timely filing guidelines to ensure… more
    Catholic Health (08/08/25)
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  • Senior Manager Product Strategy

    CVS Health (Albany, NY)
    At CVS Health , we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming ... health care. As the nation's leading health ...evaluation of clinical program outcomes using Rx and medical claims data. You will champion the value of the… more
    CVS Health (07/30/25)
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  • Clm Resltion Rep III, Hosp/Prv

    University of Rochester (Rochester, NY)
    …open account receivables to successful closure. Responsible for an effective claims follow-up to obtain maximum revenue collection. Researches, corrects, resubmits ... claims , submits appeals and takes timely and routine action...+ Reviews and works all insurance credits in electronic health record. + Enters electronic health record… more
    University of Rochester (08/09/25)
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  • Clm Resltion Rep III, Hosp/Prv

    University of Rochester (Albany, NY)
    …open account receivables to successful closure. Responsible for an effective claims follow-up to obtain maximum revenue collection. Researches, corrects, resubmits ... claims , submits appeals and takes timely and routine action...retractions. Reviews and works all insurance credits in electronic health record. Enters electronic health record notes,… more
    University of Rochester (08/07/25)
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  • Litigation Specialist, GL (Construction)

    Travelers Insurance Company (New York, NY)
    …resolving assigned Specialty Liability related Bodily Injury and Property Damage claims . Provides quality claim handling throughout the claim life cycle (customer ... staff. **What Will You Do?** + Directly handles assigned claims . + Provides quality customer service and ensures file...the job. **What Is in It for You?** + ** Health Insurance** : Employees and their eligible family members… more
    Travelers Insurance Company (07/08/25)
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  • Accounts Payable/Accountant - Eddy Senior Care…

    Trinity Health (Schenectady, NY)
    …Department. + This position is responsible for reviewing coding and approving all claims /invoices in the accounts payable system. + Works with vendors and medical ... discrepancies and eligibility. + Processes daily mail and prepares claims to be entered into our EMR to determine...local law. Our Commitment to Diversity and Inclusion Trinity Health is a family of 115,000 colleagues and nearly… more
    Trinity Health (06/28/25)
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  • Director, Integrated Evidence and Digital…

    Otsuka America Pharmaceutical Inc. (Albany, NY)
    **Director, Integrated Evidence & Digital Health ** Otsuka is constantly aiming to advance our business by delivering successful new products and advancing patient ... Director to support both Global Integrated Evidence and Digital Health R&D team. The successful candidate will collaborate closely...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more
    Otsuka America Pharmaceutical Inc. (07/01/25)
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  • General & Product Liability Complex Claim Examiner…

    Sedgwick (Rochester, NY)
    …- Hybrid **PRIMARY PURPOSE** : To analyze complex or technically difficult general liability claims to determine benefits due; to work with high exposure claims ... involving litigation and rehabilitation; to ensure ongoing adjudication of claims within service expectations, industry best practices and specific client service… more
    Sedgwick (08/08/25)
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  • Claim Adjuster - Liability

    Sedgwick (Albany, NY)
    …- Liability **PRIMARY PURPOSE:** To analyze mid- and higher-level general liability claims to determine benefits due; to ensure ongoing adjudication of claims ... standards and industry best practices; and to identify subrogation of claims and negotiate settlements. **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Manages… more
    Sedgwick (08/08/25)
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