- Champlain Valley Educational Services BOCES (Plattsburgh, NY)
- Hourly Claims Auditor Reply By: May 16, 2025 Salary: $26 Hourly Position Details: Weekly review of all CVES, CEWW Health Insurance Consortium, and Workers' ... typically on Wednesday each week with potential for carryover to Thursday. Periodically, Claims Auditor is called for on-demand checks. The claims auditor… more
- Centers Plan for Healthy Living (Staten Island, NY)
- …Responsible for the auditing functions of Centers Plan for Healthy Living (CPHL) claims . Collaborates with other Health plan departments and Management to ensure ... claims are processed in accordance with Federal, State and...supervision. PRIMARY RESPONSIBILITIES: + Conducts monthly audits of CPHL claims utilizing CPHL guidelines, policies and procedures or any… more
- ManpowerGroup (New York, NY)
- Jefferson Wells is seeking an experienced **Insurance Auditor with Life Claims ** expertise to join our team. The successful candidate will be responsible for ... compliance with company policies, industry standards, and regulatory requirements. The auditor will analyze the claims documentation and processes, identify… more
- New York State Civil Service (Albany, NY)
- NY HELP Yes Agency Taxation & Finance, State Title Auditor 1 (Tax)/ Auditor Trainee 1 (Tax)/ Auditor Trainee 2 (Tax) (NY HELPS) Occupational Category ... City Albany State NY Zip Code 12227 Duties Description Auditor 1 (Tax) performs on-site field audits and examinations...and advocate disputed cases at BCMS conferences and Small Claims Hearings. May participate at hearings as a witness… more
- New York State Civil Service (New York, NY)
- NY HELP Yes Agency State Comptroller, Office of the Title Auditor 1, SG-18, Auditor Trainee 2, (Equated to SG-16), Auditor Trainee 1, (Equated to ... various tests, reviews, reconciliations, analyses and evaluations of accounts, claims , records, and procedures.o Assists in ongoing audit/examination strategy and… more
- Sedgwick (Buffalo, NY)
- …Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Attorney Auditor As an Attorney Auditor at Sedgwick, you'll have the opportunity ... physical, financial and professional needs. **PRIMARY PURPOSE OF THE ROLE** The Attorney Auditor reviews legal and non-legal invoices on behalf of our clients for… more
- Humana (Albany, NY)
- …Coding Quality Team is looking is an experienced and well-grounded medical coding auditor to quality review the inpatient hospital claims for proper ... this role, you will conduct quality reviews of coding processes within the Claims Cost Management organization, including offshore and vendor partners, with a focus… more
- Mohawk Valley Health System (Utica, NY)
- SUPV CODING AUDITOR & EDUCATOR Department: MEDICAL GROUP ADMINISTRATION Job Summary The Supervisor Coding Audit and Education is responsible for overseeing medical ... and education initiatives within the Medical Group. This role supervises Coding Auditor & Educators and conducts coding audits, ensuring adherence to national… more
- New York State Civil Service (New York, NY)
- …HELP No Agency Attorney General, Office of the Title Forensic Auditor : Investigate Complex Healthcare Fraud (6383) Occupational Category Financial, Accounting, ... Criminal Justice DivisionMedicaid Fraud Control Unit - New York CityForensic Accountant/ Auditor Reference No. MFCU_NYC_FAA_6383Salary is $66,964 + $3,400 in location… more
- Zurich NA (New York, NY)
- Chief Auditor - Zurich Cover-More 123124 **About Us** **Zurich Group Audit** Zurich Group Audit is a diverse international team of over 250 colleagues from 33 ... as Zurich Cover-More integrates the newly acquired Travel Guard business. The Chief Auditor Zurich Cover-More has a global remit and will be responsible for… more
- Axis (New York, NY)
- …request for candidates taking part in the selection process. **Sarbanes Oxley (SOX) Auditor ** **How does this role contribute to our collective success?** The SOX ... auditor will assist in delivering the annual SOX project...variety of stakeholders across the business such as Finance, Claims , Operations, Reserving and Risk Funding. This role will… more
- Boar's Head Brand/Frank Brunckhorst Co., LLC (Brooklyn, NY)
- …product specifications, allergen forms, weight and tare information, and other product claims , as applicable. + Maintain accurate supplier information in the QMS ... Registrations + Valid Driver's License with acceptable motorist history required. + Auditor Certification required (ie American Society for Quality - Certified Food… more
- Highmark Health (Albany, NY)
- …Professional Coder (CPC), Certified Outpatient Coder (COC), Certified Professional Medical Auditor (CPMA) + 5 years with hospital or physician coding and/or ... and communication skills Preferred + Associate's Degree + 3 years with claims processing and data management + Past auditing and strong education/training background… more
- City of New York (New York, NY)
- …submit approximately 4500 payment requests annually. DDC seeks a Capital Payment Auditor to review and process these payment requisitions. To process these ... and task order registrations (in FMS3); and adjust payment voucher(s) due to liens, claims and assignments. The candidate will use the DDC automated ledger system to… more
- Healthfirst (NY)
- …**Minimum Qualifications:** + High school diploma or GED + Strong claims knowledge and internal process knowledge preferred. + Quality Assurance/Auditing experience ... PowerPoint (creating and editing presentations). + Proficiency in using Claims processing systems (preferably MHS) **Preferred Qualifications:** + Associate or… more
- City of New York (New York, NY)
- …of guidance. - Conduct and perform reviews/audits and analyze reimbursement claims , conduct field/site visits to ensure compliance with Local laws/regulations, ... Comptroller's Directives and any other City mandate. - Under supervisory direction, conduct detailed fiscal/operational and financial audit reviews to evaluate systems of internal control effectiveness. This includes reviews of invoices, Certified Payroll… more
- Healthfirst (NY)
- …service appeals utilizing appropriate sources of information; including eligibility, claims , authorizations, service forms, faxes, and any additional information ... required to complete the request. Analyze errors and determine root causes for appropriate classification, trending, and remediation. + Record/track quality assessment scores and provide feedback to reduce errors and improve processes and performance to ensure… more
- Healthfirst (NY)
- …job aids, regulatory requirements, and case documentation including eligibility, claims , authorizations, faxes, and any additional information required to complete ... the audit. + Review and investigate appeals and grievances requests to ensure all requests are identified, classified, and fully resolved in a compliant manner. + Review clinical documentation for accuracy, completeness identifying any discrepancies or… more
- City of New York (New York, NY)
- …reports. - Participates in and reviews the processing of fiscal documents, claims , financial statements, and the accounting for the receipt, deposit and disbursement ... of large sums of money. - Performs work using information available in various phases of the accounting systems, account relationships and established techniques for computing and verifying accounting data. - Examines, analyzes, reconciles, adjusts and… more
- City of New York (New York, NY)
- …relating to cost allocation. The Finance Office is recruiting for one (1) Management Auditor II to function as an Administrative Claims Preparer who will: - ... Job Description APPLICANTS MUST BE PERMANENT IN THE MANAGEMENT AUDITOR CIVIL SERVICE TITLE, OR BE PERMANENT IN A...COMPARABLE TITLE ELIGIBLE FOR 6.1.9 TITLE CHANGE Bureau of Claims and Reimbursement (BCR) is responsible for the daily… more