• Senior Encounter Data Management Professional

    Humana (Albany, NY)
    …to assignments. The Senior Encounter Data Management professional ensures data integrity for claims errors that result from the data exchange between Humana and its ... to make an impact** **Required Qualifications** **5 years of medical claims processing/auditing or encounter data management experience** **Demonstrated deep dive… more
    Humana (05/31/25)
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  • Pharmacy Billing Specialist

    Elderwood (Buffalo, NY)
    …living facility and private pay pharmacy claim billing + Troubleshoot rejected insurance claims resulting in payments + Prior Authorizations required from ... + Electronic billing of Medicare, Medicaid and Third Party Insurance pharmacy claims utilizing Framework LTC Pharmacy...and internal) Base wages increase with experience! Qualifications + Associate 's Degree or High School diploma (or GED) and… more
    Elderwood (03/29/25)
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  • Director, Grievance and Appeals

    Humana (Albany, NY)
    …and/or other end compliant inquiries. + Has 6-7 direct reports including Associate Directors, Managers, and Senior Professionals + Provides strategic direction and ... efficiencies + Collaborates with upstream business partners such as Claims , Clinical Guidance, and the Provider Network to identify...Health Savings Accounts + Flex Spending Accounts + Life Insurance + 401(k) + PTO including 9 paid holidays,… more
    Humana (05/30/25)
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  • Senior Risk Analyst

    Port Authority of New York and New Jersey (New York, NY)
    …and analysis to support underwriting disclosure for insurers/reinsurers + Interact with insurance brokers, claims adjusters and attorneys + Prepare Board ... the protection of the agency's balance sheet through contractual risk transfer, insurance placement and policy administration. The incumbent will work across the… more
    Port Authority of New York and New Jersey (06/10/25)
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  • Pharmacy Access Rep III - Home Infusion

    University of Rochester (Rochester, NY)
    …to acquire necessary information and assembly of documentation necessary to submit claims to the patient's insurance for approval including prior authorization ... that prevent patients from receiving their medications. Duties will include insurance coverage determination, patient out of pocket determination, determination of… more
    University of Rochester (05/28/25)
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  • Crime Victims Specialist 1/Trainee

    New York State Civil Service (Albany, NY)
    …Victims Specialist (CVS) 1 is to review and process compensation and medical claims filed by crime victims or their survivors for unreimbursed compensable expenses ... able to communicate effectively, both verbally and in writing, with victims, insurance companies, and law enforcement agencies. Specific duties include but are not… more
    New York State Civil Service (06/03/25)
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  • Surveillance Investigator

    Allied Universal (Albany, NY)
    Advance Your Career in Insurance Claims with Allied Universal(R) Compliance and Investigation Services. Allied Universal(R) Compliance and Investigation Services ... **- $2** **4** **/** **hr** **RESPONSIBILITIES:** + Conduct independent investigations of insurance claims across a range of coverage types, including workers'… more
    Allied Universal (05/29/25)
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  • Senior Actuarial Analyst

    Zurich NA (New York, NY)
    …actuarial models, or capital modeling. + Support Finance, market-facing business units, Claims , Risk, Capital Management, and other functions on reserving and make ... towards strategic business decisions. + Support loss reserve calculations for general insurance business under various bases. + Ensure that the claims … more
    Zurich NA (06/07/25)
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  • Administrative Assistant

    Robert Half Office Team (Syracuse, NY)
    …intake processes to ensure a seamless experience for all visitors. * Handle insurance authorizations and claims administration with precision and efficiency. * ... and manage time effectively in a fast-paced environment. * Experience with insurance authorization, claims processing, and patient intake. * Attention to… more
    Robert Half Office Team (06/05/25)
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  • Attorney/Lawyer

    Robert Half Legal (New Hyde Park, NY)
    …in civil litigation liability defense, is seeking a full-time Personal Injury Defense Associate with 5-8 years' experience to join our team. This hybrid position ... necessary. About the Role: We are looking for an associate with superior research and writing skills who can...defense matters related to sexual misconduct, abuse, and neglect claims . + Substantial Motion Practice: Draft, research, and effectively… more
    Robert Half Legal (05/22/25)
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