- Grant Thornton (New York, NY)
- As a Process Risk & Claims Audit Manager, you will get the opportunity to grow and contribute to our clients' business needs by helping them understand their ... and help you achieve more, confidently. Your day-to-day may include: + Leverage claims operations experience and claim audit experience to review and analyze… more
- Lincoln Financial (Albany, NY)
- …experience. + Effectively utilize and implement policies & procedures regarding medical terminology, duration, functionality documentation, and overall claims ... multiple product lines. You will perform and deliver on appeals claims assignments/projects while simultaneously leveraging and applying knowledge. You will analyze… more
- Axis (New York, NY)
- …taking part in the selection process. About the Team AXIS is hiring a Claims Specialist - Primary Casualty for its North America Claim Team. This role involves ... managing primary claims for AXIS US Primary Casualty policies. How does...ability to document claim activities and decisions comprehensively for audit support. Role Factors This role requires you to… more
- Axis (New York, NY)
- …request for candidates taking part in the selection process. **Job Description: Senior Claims Specialist** AXIS is seeking a Senior Claims Specialist to join ... Claims team reporting to the Manager of Casualty Claims . This position requires senior claims management...practices measured by monthly Quality Assurance and Management Initiated Audit scores as well as the implementation of Management… more
- Sedgwick (Albany, NY)
- …management reports and takes appropriate action. + Performs quality review on claims in compliance with audit requirements, service contract requirements, and ... Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Team Leader - Liability **PRIMARY PURPOSE** : To...benefits package is offered including but not limited to, medical , dental, vision, 401k and matching, PTO, disability and… more
- Cardinal Health (Albany, NY)
- … medical terminology; E/M rules, teaching physician guidelines, and/or medical necessity defense reviews; healthcare compliance audit methodology, principles ... detection and correction of documentation, coding, and billing errors and/or medical necessity of services billed. Particular areas of focus include: evaluation… more
- Jacobs (Buffalo, NY)
- …the Contract, determine validity * Day-to-day tracking, review, and management of delay claims assigned to the successful candidate * Audit contractor's claim ... firm, then Jacobs is where you belong. This candidate will work in the claims department, analyzing delay claims brought against the State within a geographic… more
- Philadelphia Insurance Companies (Melville, NY)
- …of Ward's Top 50 and rated A++ by AM Best. We are looking for a Sr. Claims Examiner - PIP to join our team! Summary: Analyze insurance claims to determine extent ... or deny coverage; investigate to establish proper reserves; and settles or denies claims in a fair and expeditious manner. Communicates with all relevant parties and… more
- CVS Health (Albany, NY)
- …all with heart, each and every day. **Position Summary** The Quality Specialist will audit pre and post payment claims for accuracy and eligibility transactions. ... identifying errors, necessary corrective measures, and may participate in special audit assignments. **Required Qualifications** + 1+ years of experience working in… more
- Molina Healthcare (Rochester, NY)
- …combination of education and experience **PREFERRED EXPERIENCE:** 3+ years healthcare Medical claims auditing **PHYSICAL DEMANDS:** Working environment is ... claim audits including, but not limited to; vendor, focal, audit the auditor. Confirm that documentation is clear and...to ensure accuracy in auditing of critical information on claims ensuring adherence to business and system requirements of… more