- Sedgwick (Albany, NY)
- …as a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Representative | Auto | Remote Are you looking for an opportunity to ... and professional needs. **ARE YOU AN IDEAL CANDIDATE?** Join our team as a Claims Representative focused on Property Damage and low touch auto claims . If you… more
- CDPHP (Latham, NY)
- …these values and invites you to be a part of that experience. The Claims Representative shall assume full responsibility and ownership for all aspects regarding ... and Billing to resolve provider inquiries as defined within Claims Operations procedures. The Claims Representative is required to handle multiple product… more
- Sedgwick (Albany, NY)
- …to Work(R) Fortune Best Workplaces in Financial Services & Insurance Workers' Compensation Claims Representative | NY Lost-Time Experience | NY Licensing **Are ... Apply your knowledge and experience to adjudicate complex customer claims in the context of an energetic culture. +...YOU AN IDEAL CANDIDATE?** To analyze **New York Lost-Time** claims on behalf of our valued clients to determine… more
- Ryder System (Albany, NY)
- …**Job Description** : **SUMMARY** This position handles worker's compensation claims under Ryder's self-insured, self administered worker's comp program. **ESSENTIAL ... FUNCTIONS** Investigates and resolves low to high exposure worker's compensation claims pursued against Ryder and our insured customers Ensures the most appropriate… more
- University of Rochester (Albany, NY)
- …the individual, and internal equity considerations._ **Responsibilities:** GENERAL PURPOSE The Claims Resolution Representative III is responsible for working ... appeal process taking timely and routine action to resolve unpaid claims . The Claims Resolution Representative III reports to Accounts Receivable Management.… more
- Ryder System (Albany, NY)
- …(http://ryder.com/job-applicant-privacy-policy) ._ **Job Description** : **Summary** The Director Claims directs activities within the General and Auto Liability ... Claims , Physical Damage Repairs and Property and Cargo ...to verify the legitimacy of an interview or Ryder representative , please contact Ryder at ###@ryder.com or ###. **Current… more
- Travelers Insurance Company (Albany, NY)
- …beacon of hope that guides our customers back to stability. At Travelers, our Claims Organization isn't just a department; it's the beating heart of our promise to ... you will be responsible for managing, evaluating, and processing claims in a timely and accurate manner. In this...claim handling experience or successful completion of Travelers Claim Representative training program. **What Is in It for You?**… more
- New York State Civil Service (Albany, NY)
- …Yes Agency Attorney General, Office of the Title Senior Consumer Frauds Representative or Consumer Frauds Representative Trainee (NY HELPS) Occupational Category ... of health care complaints, including, but not limited to billing and claims reimbursement disputes; denials of coverage for medical treatment, prescriptions, and… more
- Elevance Health (Latham, NY)
- **Broker Service Concierge Representative ** **Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person training ... is granted as required by law._ The **Broker Service Concierge Representative ** is responsible for providing dedicated operational support and expertise, as… more
- Ellis Medicine (Schenectady, NY)
- The Accounts Receivable Representative will be responsible for achieving accurate and timely accounting of all Inpatient and Outpatient accounts receivable as set by ... outstanding accounts receivable with insurance companies and patients. + Claims in dispute with payers are reviewed daily to...the provider and payers are in agreement for appropriate claims reimbursed. + Monthly meetings with all payers to… more
- Cardinal Health (Albany, NY)
- …done. **The Accounts Receivable Specialist II is responsible for processing insurance claims and billing. They will work within the scope of responsibilities as ... and support from AR & Billing leadership teams.** **_Responsibilities_** + Processes claims : investigates insurance claims ; and properly resolves by follow-up &… more
- Momentive Performance Materials Inc. (Niskayuna, NY)
- Job Title: Senior Customer Service Representative Summary:In this role, you will be the primary contact for customer support-related activities. You will provide ... focus on execution. + Receive, enter, and manage customer non-conformance claims , ensuring accurate complaint entry, coding, coordinator assignment, and clear… more
- CVS Health (Albany, NY)
- …CVS Aetna has an opportunity available for a full time Customer Service Representative in the Behavioral Health team. This role provides advocate care to assist ... the member with a clear path to care, claims understanding and resolution and educates the member with...educates the member with online resources. The Customer Service Representative guides the member through their members plan of… more
- Elevance Health (Latham, NY)
- **Utilization Management Representative I** **Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person training ... an accommodation is granted as required by law._ The **Utilization Management Representative I** will be responsible for coordinating cases for precertification and… more
- MVP Health Care (Schenectady, NY)
- …To achieve this, we're looking for an **Associate, Bilingual Medicaid- Member Service Representative ** to join #TeamMVP. This is the opportunity for you if you have ... interaction **Your key responsibilities:** + The Associate, Medicaid Member Service Representative is responsible for providing optimum customer service as required… more
- Molina Healthcare (Albany, NY)
- …setting. **Required Experience** + 3 - 5 years customer service, provider service, or claims experience in a managed care setting. + 3-5 years' experience in managed ... healthcare administration and/or Provider Services. + 5 years' experience in provider contract negotiations in a managed healthcare setting ideally in negotiating different provider contract types, ie, physician, group and hospital contracting, etc. + Working… more
- Molina Healthcare (Albany, NY)
- …member eligibility and covered benefits, Provider Portal, and status of submitted claims . * Ability to effectively communicate in a professionally setting. **Job ... Qualifications** **REQUIRED EDUCATION** : HS Diploma or equivalent combination of education and experience **REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES** : 1-3 years Sales and/or Customer Service experience in a fast paced, high volume environment… more
- Highmark Health (Albany, NY)
- …ensure they utilize various means of automated communication, as well as, claims and electronic data interchange and electronic funds transfer. Collaborate with ... sales and customer service to respond to client/broker/member inquiries regarding provider contract, claim/member issues or provider file/record/directory discrepancies. Consult with dental director/dental advisers regarding clinical-related questions and… more
- Molina Healthcare (Albany, NY)
- …of pharmacy prior authorization requests and/or appeals. * Explains point-of-sale claims adjudication, state, NCQA and CMS policies/guidelines, and any other ... necessary information to providers, members and pharmacies. * Assists with clerical tasks and other day-to-day pharmacy call center operations as delegated. * Effectively communicates plan benefit information, including but not limited to: formulary… more
- Ryder System (Albany, NY)
- …**SUMMARY** This position supervises adjusters and directly handles claims within Ryder's self-insured, self-administered liability program. Oversees claim-handling ... complex and high exposure bodily injury and property damage claims . **Maintain an active inventory of claims ,...to verify the legitimacy of an interview or Ryder representative , please contact Ryder at ###@ryder.com or ###. **Current… more