Job Summary Analyze, review, and process suspended claims, predetermination, and Service Requests based on industry standards and clinical guidelines. Research, analyze, and investigate member benefits, policy and...
MetroPlusHealth provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care,...
Pelago is the world's leading virtual clinic for Substance Use Management. Our program provides guidance, support and treatment for members seeking to overcome their tobacco, alcohol and opioid use. From unhealthy habits to active substance use...
Required Qualifications (as evidenced on attached resume):Associates degree (foreign equivalent or higher). In lieu of degree, two (2) years of full-time experience in a medical setting may be considered. Four (4) years of full-time experience...
Description The Claims Manager is responsible for promptly reporting and managing claims from workers' compensation, auto, property, and general liability. The candidate will be able to analyze mid-level claims to ensure accurate and...
What You'll Do ESSENTIAL JOB RESPONSIBILITIES include but are not limited to: Support and demonstrate IMA's core valuesValue and understand the importance of diversity, equity, and...
A leading professional services organization located in Flushing/Queens is seeking a new Claims Associate, Workers Compensation Examiner. Responsibilities: The Workers Compensation Examiner will: Review of...
Description Position at MTA Headquarters JOB TITLE: Senior Owner - Insurance Programs Administration Claims SALARY RANGE: $85,000 - $90,000 HAY POINTS: 496 DEPT/DIV: Risk Management...
OverviewWorks directly with management on highly visible projects to understand business needs and challenges of managed care payors and to develop innovative solutions to meet those needs. Gathers requirements, performs analysis, designs new or...
Job Description HumanHire is working with one of the largest insurance companies in New York, to help find a Claims Analyst for their White Plains office. This company has been around for over 75 years and...