- Molina Healthcare (Rochester, NY)
- …Contracted Provider disputes and appeals to ensure adherence with Molina claims processing standards and provider contractual agreements. Includes responsibility ... including 2 years in a manager role. * Experience reviewing all types of medical claims (eg CMS 1500, Outpatient/Inpatient, Universal Claims , Surgery,… more
- Cognizant (Albany, NY)
- …+ 1 year of Facets experience. + Experience in the analysis and processing of claims for payments, utilization review/quality assurance procedures. + Must ... ET **Experience:** A minimum of 2 years of claim processing is required. **Travel:** None required **About the role:**...is required. **Travel:** None required **About the role:** As Claims Processor (with Facets), you will be responsible for… more
- Sedgwick (Albany, NY)
- …total loss evaluations, and related expenses to effectively negotiate first and third party claims . + Knowledge of total loss processing , State salvage forms and ... Work(R) Fortune Best Workplaces in Financial Services & Insurance Commercial Auto Claims Representative **PRIMARY PURPOSE** : To analyze and process low to mid-level… more
- DePaul (Rochester, NY)
- …and Claims Manager to manage the organization's insurance procurement and claims program. This includes managing the reporting, processing , and adjustment of ... Assist with allocation of premiums by location etc. + Manage the reporting, processing , and adjustment of claims , including preparation and submission of notice… more
- Sedgwick (Albany, NY)
- …Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Examiner, Auto Bodily Injury (Litigation Required) **PRIMARY PURPOSE** : To analyze ... and process complex auto and commercial transportation claims by reviewing coverage, completing investigations, determining liability and evaluating the scope of… more
- Guardian Life (Albany, NY)
- …MS Word/Excel/PP + College degree preferred or equivalent work experience + Claim processing experience preferred or working knowledge of claims processes + ... As the ** Claims Case Manager I** , **Supplemental Insurance,** you...corresponding type of service codes and benefit amounts for processing + Assess file to determine if benefits are… more
- Port Authority of New York and New Jersey (New York, NY)
- …of claim handling including coverage, investigation, compensability, medical management, disability management, evaluation/reserving, recovery, and resolution. ... authorized TPA, as well as internal staff and external medical and legal professionals. Act as the primary point...on valuation of the exposure and strategy to resolve claims . Oversee the accident reporting process to ensure that… more
- MVP Health Care (Rochester, NY)
- …**Your key responsibilities:** + Mentor, support, and build a high-performing team within Claims Operations. + Supervise claims processing activities related ... thinking and continuous improvement. To achieve this, we're looking for a Leader, Claims Support to join #TeamMVP. If you have a passion for Operational Excellence,… more
- WMCHealth (Valhalla, NY)
- …diploma and four years of clerical experience, one year of which included the processing of patients' medical insurance claims as the primary function ... is no substitution for the one year of specialized experience processing patients' medical insurance claims . *Special Note: Education beyond the secondary… more
- CVS Health (Albany, NY)
- …all dollar amount level on customer service platforms by using technical and claims processing expertise. + Applies medical necessity guidelines, determine ... communications, organizational, and interpersonal skills. **Preferred Qualifications** + DG system claims processing experience. + Demonstrated ability to handle… more