- RiseBoro Homecare Inc. (Brooklyn, NY)
- …+ Support the Risk Manager in tracking insurance-covered litigation matters. File claims with insurance companies for claims and lawsuits as needed. + Draft ... advocacy letters and responses to administrative complaints. + Legal research and writing. + Perform other related duties as assigned. COMPETENCIES + Excellent business writing skills (professional writing sample will be required). Previous legal research and… more
- Mount Sinai Health System (New York, NY)
- …knowledge of a health care EMR such as Epic/Clarity, eCW, etc.; a payor claims system such as Facets, Amisys, etc.; or a hospital/provider system such as IDX, ... **Responsibilities** 1. Analyzes data requests using information technology, enrollment, claims , pharmacy, clinical, contract, medical management, financial, administrative and… more
- Compass Group, North America (Brooklyn, NY)
- …mandatory safety and sanitation training* Take the lead in working with the Home Office Risk Management team in responding to or managing any safety and claims ... and settling of team members, foodborne illness, liquor liability and guest claims * Work with local OSHA, sanitation or Everclean inspectors to support inspections… more
- Brighton Health Plan Solutions, LLC (New York, NY)
- …of strategic projects that span organizational boundaries, manages multiple high- risk projects, including projects involving external vendors and multiple business ... more work streams, including: Client Implementation, Enrollment & Eligibility, Claims processing & Reimbursements, Member/Provider self-service, Customer Service, Legal… more
- MTA (Bronx, NY)
- …and at reducing collisions and minimizing expenses related to litigation and claims . Execute the development and implementation of an enhanced de-escalation training ... avoidance features, to improve employee availability and reduce IOD claims . Serve as co-chair of the DOB Assault Committee...which is developing recommendations to reduce assaults and the risk of injury from other hazards and to monitor… more
- Molina Healthcare (Yonkers, NY)
- …responsible for the holistic management of the external vendor relationships for Claims and Enrollment activities (along with other Core Ops areas of ... and benefit realization + Demonstrates deep understanding of Core Operations, Claims and Enrollment processes, deliverables, vendor partners and technology platforms… more
- Healthfirst (NY)
- …and CMS guidelines and to ensure member satisfaction + Lead cross functional risk assessment root cause analysis activities to identify, assess and address key risks ... institution + Leadership experience in a high-volume production billing, enrollment, claims , call center environment or related environment. + Basic understanding of… more
- MTA (New York, NY)
- …program control activities for C&D (cost estimating, cost control, scheduling, and risk management) for the entire capital program. Works within the Systems Business ... for escalated items related to cost estimates, schedules, change orders, claims , time extension requests, and disputes. Evaluate actual project performance, … more
- CVS Health (Albany, NY)
- …each and every day. Are you a strategic thinker with a passion for risk analysis and underwriting excellence? Join our dynamic team as an **Underwriter** , where ... driving business growth. What You'll Do + **Lead with Insight:** Analyze and assess risk for new and renewal employer group contracts across a diverse book of… more
- CVS Health (Albany, NY)
- …medication reconciliation (if within scope of practice), fall assessment if fall risk identified. - Complete inpatient confinement calls and monitoring for discharge ... - Uses discretion to apply strategies to reduce member risk . - Facilitates overall care coordination with the care...advocate for themselves. The TOC team will review prior claims to address potential impact on current case management… more