- CDPHP (Latham, NY)
- …member-focused, and community-based not-for-profit health plan that offers high- quality affordable health insurance to members throughout New York. ... The company values people, quality , innovation, and community, and its corporate culture supports...you to be a part of that experience. The Risk Adjustment Coding Specialist will be responsible for the… more
- Otsuka America Pharmaceutical Inc. (Albany, NY)
- …Summary** We are seeking an experienced and dynamic Executive Director of R&D Global Quality to join our team. This pivotal role will be responsible for leading a ... global team focused on R&D Quality . This global role includes direct reports in the...Company policy and strategy and gain a consensus of risk mitigation approaches. **Key Responsibilities:** + **Inspection Readiness:** Ensure… more
- Travelers Insurance Company (Melville, NY)
- …negotiating and resolving assigned General Liability Bodily Injury and Property Damage claims . Provides quality claim handling throughout the claim life cycle ... **What Will You Do?** + Directly handles assigned severity claims . + Provides quality customer service and...external resources for specific activities required to effectively evaluate claims , such as Subrogation, Risk Control, nurse… more
- Evolent (Albany, NY)
- …for the culture. **What You'll Be Doing:** Job Description **Analyst, Integration Quality ** Integration testing in the healthcare ecosystem requires complete end to ... test execution + Consult with the manage and report risk , issues, and decisions with the lead / manager...Knowledge of Medicare, Medicaid, Commercial Plans and understanding on claims workflow, members, providers + A minimum of 1… more
- Travelers Insurance Company (Melville, NY)
- …negotiating and resolving assigned Specialty Liability Bodily Injury and Property Damage claims . Provides quality claim handling throughout the claim life cycle ... **What Will You Do?** + Directly handles assigned severity claims . + Provides quality customer service and...external resources for specific activities required to effectively evaluate claims , such as Subrogation, Risk Control, nurse… more
- Travelers Insurance Company (Melville, NY)
- …evaluating, reserving, negotiating and resolving assigned serious and complex Specialty claims . Provides quality claim handling throughout the claim life ... external resources for specific activities required to effectively evaluate claims , such as Subrogation, Risk Control, nurse...claim results of others. + Apply the Company's claim quality management protocols, and metrics to all claims… more
- Boar's Head Brand/Frank Brunckhorst Co., LLC (Brooklyn, NY)
- …the Boar's Head Audit Team in conducting comprehensive Food Safety and Product Quality audits across a variety of venues, including Food Service Operations, Retail ... be responsible for ensuring that suppliers consistently adhere to finished product quality standards, aligning with the high expectations of the Boar's Head Brand.… more
- MVP Health Care (Schenectady, NY)
- …Integrity & Cost Containment** to lead enterprise-wide initiatives that ensure claims are paid accurately, ethically, and efficiently. This high-impact role ... goals. + Oversee pre- and post-payment integrity programs including claims editing, audits, subrogation, readmission reviews, and coordination of benefits.… more
- Sedgwick (Albany, NY)
- …the right candidate for this or other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating ... regarding their vehicle's cost of repair estimate and explains claims /repair process + Maintains accurate vehicle's cost of repair...as assigned. + When not in the field, assist quality assurance team and be available for desk appraisal… more
- AIG (New York, NY)
- …brings together a seamless global controlled master program to deliver upon client's risk transfer needs in the local geographies in which they operate (aligned with ... and competitive environment dynamics including technological needs, key business drivers, risk analytic needs, and financial elements and demonstrate the value AIG… more