- NJM Insurance (Trenton, NJ)
- …and trends related to fraudulent Personal Lines and Commercial Lines policies and claims . + Conduct background research on available public databases to support ... + Triaging and analyzing scorecards and outputs from predictive models for General Claims , Personal Lines, Personal Injury Protection (PIP) claims and Medical… more
- City of New York (New York, NY)
- …to program administration. - Utilizes automated systems and tools to support public health research and analysis to ensure claims submitted to the Grantors are ... and judgment, performs beginning level analysis in public health research cost. - Monitor the research operation costs of city, federal, state and private grant… more
- Academy Sports + Outdoors (Katy, TX)
- …planning and setting goals that utilize extensive experience, judgment, and research Responsibilities: + Analyzing online orders to determine fraudulent activity and ... functions of each different vendor portal used to dispute claims with various financial institutes + Create reports using...weekly Fraud Analysis + Perform dispute review of Fraud claims that may be submitted in error or may… more
- Molina Healthcare (OH)
- …Procedures, Standard Operating Procedures and other internal guidelines. + Review, research , analyze and evaluate information to assess compliancy between a process ... compliance related. + Coordinate, facilitate and document audit walkthroughs. + Research , collect or generate requested documentation. Provide timely and accurate… more
- City of New York (New York, NY)
- …timely process of revenue collection for outstanding balances. Investigate and research unidentified claims /payments received to determine its appropriateness to ... payments in compliance with financial policies and procedures. - Examine invoices, claims , fee collection or applications for recoupments, refunds and verify their… more
- Philadelphia Insurance Companies (New York, NY)
- …reviewing governance-related submissions from individual group companies, and performing research on governance best practices and procedures + Gather, prep ... the managers of the GPA department + Assist in research to support the actuarial loss reserve process reviews...Companies, Tokio Marine America, Inc., TMNA Services, LLC, TM Claims Service, Inc. and First Insurance Company of Hawaii,… more
- CareFirst (Baltimore, MD)
- …to current operations. Applies a depth of knowledge, skills, and abilities to research and to conduct process analysis and studies. + Assists in the facilitation ... payor industry, insurance products, and regulation. + Knowledge of CareFirst operations, claims systems, and policies. + Microsoft Power BI and Power BI Report… more
- Philadelphia Insurance Companies (Bala Cynwyd, PA)
- …and enhancements; develops and documents application specifications + Conducts research , evaluates and provides input to potential solutions, considering project ... the Philadelphia Insurance Companies, Tokio Marine America, Inc., TMNA Services, LLC, TM Claims Service, Inc. and First Insurance Company of Hawaii, Ltd.) is an… more
- World Insurance Associates, LLC. (Syosset, NY)
- …cases + Create monthly financial reporting packages including detailed premium, claims , membership, commission, and cash reconciliation information + Create weekly, ... + Provide timely, courteous and accurate response to all inquiries, conducting research when necessary and communicating results + Process all necessary paperwork by… more
- Center For Health Information And Analysis (Boston, MA)
- …Betsy Lehman Center is charged with fostering a statewide program of research , data analysis, and information-sharing that engages health care agencies, providers, ... (CHIA). The Betsy Lehman Center is seeking a full-time Research Assistant, Patient Safety & Maternal Health, who reports...patient safety, such as reported adverse events in medical claims and survey data + Utilize appropriate software, including… more