- City of New York (New York, NY)
- …submission and, issuing verification letters to claimants and medical providers; 2) Review and disallow claims for improper service or for exceeding the ... threshold under New York State No Fault Law; 3) Review all new claims for data accuracy...New York State Department of Financial Services correspondence; 10) Review medical providers and law firms to… more
- Molina Healthcare (Albany, NY)
- …Managed Care Experience in the specific programs supported by the plan such as Utilization Review , Medical Claims Review , Long Term Service and Support, ... the likelihood of a formal appeal being submitted. + Independently re-evaluates medical claims and associated records by applying advanced clinical knowledge,… more
- Cognizant (Albany, NY)
- …of Facets experience. + Experience in the analysis and processing of claims for payments, utilization review /quality assurance procedures. + Excellent ... to multi-task successfully? If so, please apply today! The Claims Processor, you will ensure accurate and timely adjudication...with stakeholders and other teams. **Primary Responsibilities** : + Review claim system data and verify against UB or… more
- AON (Garden City, NY)
- …thorough investigation of claim submissions and documentation to confirm coverage. + Review medical records, itineraries, and other documentation to make ... and helping colleagues reach their career goals. Responsibilities: + Review and service claims in accordance with...of claim submissions and documentation to confirm coverage. + Review medical records, itineraries, and other documentation… more
- New York State Civil Service (Endicott, NY)
- …regarding lump sum settlements; issue payments and requests for reimbursement where claims for supplemental benefits are involved; review awards to ensure ... NY HELP Yes Agency Insurance Fund, State Title Claims Service Representative 1/Trainee 1/2 - NY HELPS...for home modifications, home health care personnel, medication, and medical supplies and appliances; and review case… more
- Ryder System (Albany, NY)
- _Job Seekers can review the Job Applicant Privacy Policy by clicking here (http://ryder.com/job-applicant-privacy-policy) ._ **Job Description** : **Summary** The ... Senior Claims Representative handles complex and mid-to-high exposure bodily injury...all relevant laws and regulations as well as related medical and legal terminology + Requires strong claim technical… more
- MTA (Brooklyn, NY)
- …and/or property damage claims brought against MTA agencies. Review claims and relevant factual and medical records and varied technical information, ... Claims Manager Job ID: 11803 Business Unit: MABSTOA...damages exposures, make appropriate investigative assignments and supervise results, review and make appropriate reserve and settlement recommendations, identify… more
- Sedgwick (Buffalo, NY)
- …reviews and analyzes management reports and takes appropriate action. + Performs quality review on claims in compliance with audit requirements, service contract ... authority of the individual examiner. + Monitors third party claims ; maintains periodical review of litigated ...opportunities. + A diverse and comprehensive benefits offering including medical , dental vision, 401K on day one. _As required… more
- Staffing Solutions Organization (Albany, NY)
- …on process improvement resulting in cost savings and staff efficiencies. **Duties include:** + Review medical claims according to written procedures + Answer ... of Medical and Dental Directors, Bureau of Medical Review is recruiting for a Healthcare...routine phone calls about claims review activities + Escalate issues &… more
- Axis (New York, NY)
- … Review contracts for risk transfer evaluations, coverage analysis and tender review * Investigates potentially fraudulent claims and takes appropriate action ... Hills, NJ and Alpharetta, GA. * Highest level individual contributor directly reviewing claims to determine nature of loss, coverage provided, and scope of claim… more