- Sedgwick (New York, NY)
- …Executive General Adjuster - Northeast Region **PRIMARY PURPOSE** : To investigate claims internationally of any size or complexity, against insurance or other ... Attends litigation hearings. + Revises case reserves in assigned claims files to cover probable costs. + Prepares loss...benefits package is offered including but not limited to, medical , dental, vision, 401k and matching, PTO, disability and… more
- WSP USA (New York, NY)
- …+ Review schedule concepts, including baseline and monthly schedule updates + Review claims and related analysis and assist with response letters to contractor ... claims as necessary. + Analyze schedules, identify potential issues,...are also afforded a comprehensive suite of benefits including medical , dental, vision, disability, life, and retirement savings focused… more
- Sedgwick (Albany, NY)
- …PURPOSE OF THE ROLE:** While partnering with the injured worker, employer, and medical providers, create a case management strategy to facilitate medical ... and a successful return to work through advocacy, communication and coordination of medical services. **ARE YOU AN IDEAL CANDIDATE?** We are looking for enthusiastic… more
- SUNY Upstate Medical University (Syracuse, NY)
- …Key responsibilities include: Liaison Responsibilities: Assist in coordinating small claims paperwork in collaboration with the NYS Attorney General's Office. ... Committee Coordination: Schedule, plan, and facilitate meetings for the Patient Experience Steering Committee, Patient Experience Champion Committee and the Patient & Family Advisory Council (PFAC). Data Management and Reporting: Prepare reports and maintain… more
- Otsuka America Pharmaceutical Inc. (Albany, NY)
- …drug development programs, including: + Understanding pharmacology of drugs and unmet medical needs. + Formulating a rationale to develop the drug in accordance ... Developing and leading formal presentations of results to the medical community, in written, verbal, andvisual formats. + Analyzes...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more
- Kelly Services (Rochester, NY)
- …processing and review of prior authorization requests for both pharmacy and medical specialty drug reviews as permitted by law. Reviews are conducted in ... **Essential Responsibilities/Accountabilities** + Conduct initial medication prior-authorization, exception, and medical necessity reviews + Route cases to pharmacist/ medical… more
- WMCHealth (Poughkeepsie, NY)
- …Applicant link Job Details: Job Summary: The Patient Accounting Clerk processes insurance claims to third party health carriers for billing of medical services ... Responsibilities include initial billing, investigation and reconciliation of problem claims , insurance follow up, filing, and other clerical tasks.… more
- Otsuka America Pharmaceutical Inc. (Brooklyn, NY)
- …innovative products, with a focus on pharmaceutical products to meet unmet medical needs and nutraceutical products for the maintenance of everyday health. In ... a superior experience. The "ecosystem approach" unifies account management, medical , patient access, and market access teams to engage...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more
- CVS Health (Albany, NY)
- …Senior Claim Benefit Specialist reviews and adjudicates complex, sensitive, and/or specialized claims in accordance with plan processing guidelines. They will act as ... customer service inquiries and problems. **Key Responsibilities** + Reviews pre-specified claims or claims that exceed specialist adjudication authority or… more
- Mount Sinai Health System (New York, NY)
- …interacts with hospital employees on multiple levels, including pharmacists, medical /clinical staff, fiscal personnel, department managers, access services staff, ... primarily responsible for receiving prescriptions, addressing and rectifying rejected claims , conducting and completing necessary third party (insurance) prior… more