- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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