- City and County of San Francisco (San Francisco, CA)
- …and submission of claims to the California Victim Compensation and Government Claims Board, and monitor claim progress and payment. 5. Assist with the ... arrangement of transportation for crime victims and survivors when appropriate. 6. Conduct program educational presentations to city and community-based partners, and city residents in their communities. 7. Translate as required to meet division needs.… more
- Molina Healthcare (Covington, KY)
- …abuse, and over utilization by providers and recipients. The position will review claims data, medical records, and billing data from all types of healthcare ... the Medicaid and Medicare programs as well as Marketplace + Understanding of claim billing codes, medical terminology, anatomy, and health care delivery systems +… more
- The Boeing Company (Ridley Park, PA)
- …processes and initiatives. + Participates in the discussion of legal cases and claims with in-house and outside counsel. + Researches, acquires and provides specific ... facts and data in response to, or in anticipation of, litigation. + Prepares for interpretation and dissemination of accident investigation related materials. + Participates in field investigations. + May support production safety flight incident… more
- CVS Health (St. Paul, MN)
- …healthcare fraud cases. - Investigates to prevent payment of fraudulent claims committed by insured's, providers, claimants, customer members, etc. - Facilitates ... the recovery of company and customer money lost as a result of fraud matters. - Provides input regarding controls for monitoring fraud related issues within the business units. - Delivers educational programs designed to promote deterrence and detection of… more
- New York State Civil Service (Melville, NY)
- NY HELP Yes Agency Insurance Fund, State Title Claims Services Representative 1/Trainee 1/2 (Group 90) - NYHELPS Occupational Category Other Professional Careers ... not limited to:* Oversee all aspects of workers' compensation claims processing from inception to closing.* Initially determine the...with case analysis over the anticipated life of the claim .* Recommend cases for appeal to WCB.* Negotiate and/or… more
- Philadelphia Insurance Companies (Ewing, NJ)
- …of Ward's Top 50 and rated A++ by AM Best. We are looking for a Sr. Claims Examiner - SIU to join our team! Summary : Evaluate referred insurance claims for ... potential insurance fraud. Conduct thorough investigations of suspect insurance claims and policy applications. Conduct insurance fraud investigations in accordance… more
- C&S Wholesale Grocers, Inc. (Lathrop, CA)
- **Position Overview** As a Claims Investigator , you will be researching shortage claims based on calls received from our customer locations. These ... Description** **Description** + This position will report directly to the Claims Manager and conduct detailed investigations by recovering all documentation… more
- Mount Sinai Health System (New York, NY)
- …to Directors for potential legal intervention, and assisting in the escalation of claims that may require involvement from insurance carriers or legal entities. The ... cycle management, with a strong understanding of both hospital and professional claims processes. ? Previous experience in a role that involved analyzing contracts,… more
- New York State Civil Service (Buffalo, NY)
- …of relevant information technology, including but not limited to the Investigator Mobile Application, IC2, CIS, and Insurance Compliance Investigation Maintenance; ... Compensation Law as relates to enforcement unit procedures and related claims processes. Stay abreast of enforcement-related Workers' Compensation Board program… more
- City of New York (New York, NY)
- Job Description APPLICANTS MUST BE PERMANENT IN THE ASSOCIATE FRAUD INVESTIGATOR CIVIL SERVICE TITLE. The DSS Accountability Office (DSS-AO) is responsible for ... all statutory, regulatory, and contractual standards. The Division of Claims and Collections Division (C&C) is housed within the...levels. C&C is recruiting for (1) one Associate Fraud Investigator II to function as a Group Supervisor, who… more