- 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
- Sedgwick (Buffalo, NY)
- …management reports and takes appropriate action. + Performs quality review on claims in compliance with audit requirements, service contract requirements, and ... to Work(R) Fortune Best Workplaces in Financial Services & Insurance Workers Compensation Claims Team Lead | NY Jurisdictional Knowledge We are seeking a highly… 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 Lead I Workers Comp (Calif Exp) **PRIMARY...benefits package is offered including but not limited to, medical , dental, vision, 401k and matching, PTO, disability and… more
- Sedgwick (Albany, NY)
- …management reports and takes appropriate action. + Performs quality review on claims in compliance with audit requirements, service contract requirements and ... a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Team Lead, General Liability **PRIMARY PURPOSE** : To supervise a team of… more
- Amazon (New York, NY)
- …program around the world across all of its various use cases. Amazon's Last Mile Claims team is seeking a talented claims professional to support our rapidly ... auto program. You will lead strategy on complex bodily injury auto claims , handling pre-litigation disputes and resolving litigated claims with cross-functional… 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
- Molina Healthcare (NY)
- …Data Validation) team, assisting in the execution of CMS and internal audit activities. This position contributes to the development of chart retrieval chase ... lists by helping identify and validate source data required for medical record collection. This is an ideal opportunity for an early-career analyst with a strong… more
- DePaul (Rochester, NY)
- Overview DePaul is looking for an Insurance and Claims Manager to manage the organization's insurance procurement and claims program. This includes managing the ... reporting, processing, and adjustment of claims relating to our All-Risk Property and Business Interruption,...site visits as needed with insurance agencies for risk assessment/ audit . + Invoicing for Insurance Escrows. + Auto changes-ID… more
- Elevance Health (Latham, NY)
- … chart coding principles, clinical guidelines, and objectivity in the performance of medical audit activities. + Draws on advanced ICD-10 coding expertise, ... experience preferred. + Broad knowledge of clinical documentation improvement guidelines, medical claims billing and payment systems, provider billing… more
- Independent Health (Buffalo, NY)
- …statistics. + Perform validation of diagnosis and procedure coding by reviewing medical record documentation and/or provider claims data. Ensure coding ... will aid in training other team members, evaluating appeals, and share audit trends across the team. Expertise and proficiency demonstrated by long-standing,… more