- Axis (New York, NY)
- …opportunities the increased use of internal Severity and Coverage resources. + Compliance & Quality Assurance - Comply with best practices measured by monthly ... taking part in the selection process. **Job Description: Senior Claims Specialist** AXIS is seeking a Senior Claims...Quality Assurance and Management Initiated Audit scores… more
- Cognizant (Albany, NY)
- …coverage guidelines and regulations. * Experience in the analysis and processing of claims , utilization review/ quality assurance procedures. * Must be able ... - 4:30pm ET **Experience:** A minimum of 1 years claims processing is required. **Travel:** None required **About the...HCFA paper or EDI information. * Responsible for reviewing medical records when necessary to determine if service rendered… more
- General Dynamics Information Technology (Menands, NY)
- …Be Able to Obtain:** None **Public Trust/Other Required:** None **Job Family:** IT Quality Assurance **Skills:** Healthcare Claims , Quality Assurance ... determine the possibility of adding test cases to the Quality Assurance Regression (QAR) baseline + Add...REQUIRED TECHNICAL SKILLS: + 837 (I, P and D) Medical Claims testing experience + Knowledge of… more
- Claxton-Hepburn Medical Center (Carthage, NY)
- …detail and accuracy as it pertains to the documentation of information + Maintaining quality assurance and compliance with all regulatory agencies + CCPT and ... Internal Posting Dates: May 22, 2025-May 29, 2025 Medical Records - Medical Records Coder...to determine the hospital database and reimbursement of hospital claims . EDUCATION: Required: + High school diploma or equivalent… more
- Actalent (Clayville, NY)
- …Skills + Quality control and inspection + Data entry and admin support + Quality assurance and visual inspection + Use of calipers and inspection equipment + ... 1st Shift Quality Technician Job Description The Quality ...and prevent defects in supplied materials and verify defect claims . + Lead cross-functional teams to pursue performance improvements… more
- Centene Corporation (New York, NY)
- …activities. + Performs medical review activities pertaining to utilization review, quality assurance , and medical review of complex, controversial, or ... Medical Director to direct and coordinate the medical management, quality improvement and credentialing functions...to providers that would improve utilization and health care quality . + Reviews claims involving complex, controversial,… more
- Terumo Medical Corporation (Queens, NY)
- …Corporation (TMC) develops, manufactures, and markets a complete, solutions-based portfolio of high- quality medical devices used in a broad range of applications ... Req ID: 4615 Location: Queens, NY, US Company: Terumo Medical Corporation Department: TIS Sales - New York Metro...complaints (ie adverse events, product performance reports, etc.) to Quality Assurance (QA), and by ensuring all… more
- Sedgwick (Albany, NY)
- …until the assigned Field Case Manager arrives onsite. + Adheres to quality assurance standards. **ADDITIONAL FUNCTIONS and RESPONSIBILITIES** + Performs other ... injury referral calls from clients; gathers vital case details, obtains and provides medical status updates to the customer, and assigns a Field Case Manager (FCM)… more
- Elevance Health (Latham, NY)
- …in applicable state(s). + Requires a minimum of 10 years of experience in claims auditing, quality assurance , or clinical documentation improvement, and a ... experience preferred. + Broad knowledge of clinical documentation improvement guidelines, medical claims billing and payment systems, provider billing… more
- Sedgwick (Buffalo, NY)
- …RESPONSIBILITIES** + Performs other duties as assigned. + When not in the field, assist quality assurance team and be available for desk appraisal work as well ... with information regarding their vehicle's cost of repair estimate and explains claims /repair process + Maintains accurate vehicle's cost of repair estimate and… more