- MVP Health Care (Rochester, NY)
- Commercial Claims Processing Associate, Claims Examiner Headquarters Office, 625 State Street, Schenectady, New York, United States of America * Rochester ... thinking and continuous improvement. To achieve this, we're looking for a Medical Claims Examiner to join #TeamMVP. This is the opportunity for you if you have… more
- Sedgwick (Rochester, NY)
- …Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Workers Compensation Claims Examiner | New York Jurisdiction | Dedicated Client We are ... seeking a highly motivated and experienced Workers' Compensation Claims Examiners to join our team. The ideal candidate...ideal candidate will have at least 2 years of claims handling experience, with a strong background in New… more
- CRST (Amherst, NY)
- …analysis, and processing of-and reporting on-insurance and self-insurance programs and claims . Risk management personnel manage the company's risk by analyzing and ... purchasing risk transfer products; assessing, investigating, and settling claims to limit. ultimate liability; monitoring and assisting the work of outside legal… more
- Molina Healthcare (Rochester, NY)
- …enforcement or for payment recovery. **KNOWLEDGE/SKILLS/ABILITIES** + Reviews post pay claims with corresponding medical records to determine accuracy of claims ... of experience working in the group health business preferred, particularly within claims processing or operations. + A demonstrated working knowledge of Local, State… more
- Molina Healthcare (Rochester, NY)
- …Provider Services, Contracting and Credentialing, Healthcare Services, Member Services, Claims ) to gather documentation pertinent to investigations. + Detects ... Associate (HCAFA). + Accredited Health Care Fraud Investigator (AHFI). + Certified Fraud Examiner (CFE). To all current Molina employees: If you are interested in… more
- New York State Civil Service (Rochester, NY)
- …investigation of alleged fraud.* Designation as a Certified Fraud Examiner .* Experience with statistical sampling and/or advanced statistical training.* Knowledge ... and medical coding concepts (CPT, ICD-9/10, DRGs) and/or experience analyzing health care claims data.* A CPA is not required; but the position qualifies for CPA… more