• Senior Claim Benefit

    CVS Health (Albany, NY)
    …it all with heart, each and every day. **Position Summary** In this position, the senior Claim Benefit Specialist (OPS) reviews, researches and ... processing guidelines. May be required to learn multiple Medicaid plans. Medical claims processing experience is a basic requirement. * Works to research and… more
    CVS Health (05/16/25)
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  • Senior Corporate Compliance…

    Fujifilm (Albany, NY)
    **Position Overview** The accomplished Senior Corporate Compliance Specialist will support FUJIFILM's Corporate Compliance Program's operations to ensure high ... regulations (including Anti-Kickback Statute, Foreign Corrupt Practices Act (FCPA), False Claims Statute, and OIG's guidance of an effective compliance program) as… more
    Fujifilm (02/19/25)
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  • Senior Specialist , Provider Network…

    Molina Healthcare (Albany, NY)
    …timely validation and maintenance of critical provider information on all claims and provider databases. This multifaceted role supports both operational efficiency ... and FQHC/RHC reports. + Generates other provider-related reports, such as: claims report extractions; regularly scheduled reports related to Network Management (ER,… more
    Molina Healthcare (05/10/25)
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  • Senior Claim Benefit

    CVS Health (Albany, NY)
    …- Distributes work assignment daily to junior staff. - Trains and mentors claim benefit specialists. - Makes outbound calls to obtain required information ... handle customer service inquiries and problems. Additional Responsibilities - Reviews pre-specified claims or claims that exceed specialist adjudication… more
    CVS Health (05/16/25)
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  • Administrative Specialist 1/Trainee 1/2…

    New York State Civil Service (Albany, NY)
    …Management Specialist 1, Human Resources Specialist 1, Senior Administrative Analyst, Policyholder Services Representative 1, Claims Services ... NY HELP Yes Agency Insurance Fund, State Title Administrative Specialist 1/Trainee 1/2 - NY HELPS Occupational Category Administrative or General Management Salary… more
    New York State Civil Service (05/08/25)
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  • Sr. Claims Specialist , Worker's…

    Zurich NA (Albany, NY)
    Sr. Claims Specialist , Worker's Compensation 123309 Zurich is currently looking for a Senior Workers Compensation Claims Professional with West Virginia ... claims cycle within authority limit by estimating and validating value of claims . + Negotiate settlement of claim by establishing appropriate negotiation… more
    Zurich NA (05/07/25)
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  • Investigative Specialist 1 (Law) / Trainee…

    New York State Civil Service (Albany, NY)
    NY HELP Yes Agency Attorney General, Office of the Title Investigative Specialist 1 (Law) / Trainee (NY HELPS) Occupational Category No Preference Salary Grade NS ... relating to the investigative jurisdiction of the specific agency's bureau.* Review Claims and Notices of Intention filed against the State to determine type… more
    New York State Civil Service (05/09/25)
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  • Project Controls Specialist

    CS Energy (Albany, NY)
    The Project Controls Specialist works under the guidance of our Project Controls Leadership and in partnership with our Operations Team to provide a single point of ... Schedules, Project Forecast Sheets, and 4 Week Lookahead Reports. The Project Controls Specialist will report to the Edison, Albany, or Worchester office at least… more
    CS Energy (04/08/25)
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  • Senior Medical Stop Loss Underwriter

    Highmark Health (Albany, NY)
    …months in either Life Office Management Association (LOMA) Certified Employee Benefit Specialist (CEBS), or America's Health InsurancePlans (AHIP) **Language ... structure of a contract for a group based on claims experience, characteristics of the employee groups, etc. The...type of industry, characteristics of employee groups, or past claim experience to determine what benefits can… more
    Highmark Health (04/30/25)
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  • Senior Corporate Compliance Manager…

    United Therapeutics (Albany, NY)
    …first publicly-traded biotech or pharmaceutical company to take the form of a public benefit corporation. Our public benefit purpose is to provide a brighter ... you drive a culture of compliance with confidence and enthusiasm. The Senior Corporate Compliance Manager - Training, Communications and Policy will be responsible… more
    United Therapeutics (05/13/25)
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  • Associate Medical Stop Loss Underwriter

    Highmark Health (Albany, NY)
    …twelve months in either Life Office Management Association (LOMA) Certified Employee Benefit Specialist (CEBS), or America's Health Insurance Plans (AHIP) ... structure of a contract for a group based on claims experience, characteristics of the employee groups, etc. The...type of industry, characteristics of employee groups, or past claim experience to determine what benefits can… more
    Highmark Health (04/04/25)
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