• Surveillance Investigator

    Allied Universal (Middletown, 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 (08/09/25)
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  • Encounter Data Management Professional

    Humana (Albany, NY)
    …achieving operational and compliance key performance indicators. In addition, the associate will participate in cross functional teams and support analyzing business ... an impact** **Required Qualifications** + Minimum 1 year of experience in medical claims payment and processing + Minimum 1 year of experience analyzing and… more
    Humana (08/16/25)
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  • Medicaid Provider Hospital Reimbursement…

    Humana (Albany, NY)
    …responsible for administering complex Medicaid provider reimbursement methodologies. The associate will support existing Medicaid business and expansion into new ... closely with IT, the pricing software vendor, CIS BSS, Medicaid operations, claims operations, and other business teams involved in the administration of Medicaid… more
    Humana (08/14/25)
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  • Manager, Utilization Management (RN)

    Evolent (Albany, NY)
    …across the organization, training and development, provider relations, member services, claims management and our implementation team will also be available. **What ... - Required and Preferred** + RN Licenses (Active and Unrestricted) - Required + Associate 's degree or equivalent years of work experience.- Required + 1-2 years of… more
    Evolent (08/14/25)
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  • Encounter Data Management Professional

    Humana (Albany, NY)
    …problems within the encounter process between Humana and CMS using data analysis, claims research, and other resources to provide insight and ensure data integrity ... for Medicare/Medicaid claims errors. **Key Role Functions** + Develop business processes to ensure successful submission and reconciliation of encounter submissions… more
    Humana (08/19/25)
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  • Senior Encounter Data Management Professional

    Humana (Albany, NY)
    …The Senior Encounter Data Management Professional ensures data integrity for claims errors. The Senior Encounter Data Management Professional work assignments ... make an impact** **Required Qualifications** + 5+ years of claims operations related experience + Experience with analyzing, reconciling...SQL & Access) + Prior experience in a fast-paced insurance or health care setting + Experience with creating… more
    Humana (08/15/25)
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  • Warranty Manager

    Latham, The Pool Company (Latham, NY)
    …communicates with homeowners and dealers regarding warranty/ non warranty items ( claims , repairs, inquiries, etc.). This manager will handle escalations from ... of What You Will Do: + Reviews warranty inquiries/ claims and classifies warranty or non-warranty. + Handles Dealer/...assigned. What You Bring to the Table: (Qualifications) + Associate degree required. + 3 + years' management experience… more
    Latham, The Pool Company (08/08/25)
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  • External Service Writer

    Keith Titus Corp (Weedsport, NY)
    …and weekend rotation Company Benefits : + Aetna Meritain (2 plan health insurance options) + Company Sponsored HRA (Health Reimbursement Card) + Excellus Dental + ... Excellus Vision + Pet Insurance / Pet Discount Program (3 program options) +...confirm price table accuracy/customer billing information + Opens warranty claims , tracks & process, follow up on warranty shortages… more
    Keith Titus Corp (06/25/25)
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  • Paralegal

    RiseBoro Homecare Inc. (Brooklyn, NY)
    …defend and initiate legal proceedings. + Support the Risk Manager in tracking insurance -covered litigation matters. File claims with insurance companies for ... EDUCATION EXPERIENCE + Bachelor's Degree from and accredited college or university or: Associate Degree plus 5 years of direct paralegal experience or; High School… more
    RiseBoro Homecare Inc. (08/16/25)
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  • Clinical Research Scientist 2

    Humana (Albany, NY)
    …clinical concepts and extract clinical information from medical, pharmacy, and lab claims for analytics and modeling purposes + Translates analytic results into key ... or managed care working experience + Experience working with medical, pharmacy, lab claims + Experience working with big data and using PySpark, Spark R or… more
    Humana (08/15/25)
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