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Collaborates with professionals, health plan departments such as Claims and Medical Management, and the third party administrator staff and legal, as necessary, to investigate and facilitate resolution of individual grievances and appeals.
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This position's working relationships entail frequent interaction with all departments of the company (Finance, Underwriting, Insurance, Reinsurance, Claims, ILS, etc. This position's working relationships entail frequent interaction with all departments of the company (Finance, Underwriting, Insurance, Reinsurance, Claims, ILS, etc.
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Additional recent significant cases include the indictment and arraignment of the owner of an NYC pharmacy for allegedly stealing millions from Medicaid; the sentencing of a Bronx clinic owner for defrauding New York State out of more than $4 Million in false Medicaid claims; and the extradition, arrest, and arraignment of a Medicaid fraud ringleader.
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Developing valuation models using option pricing theory, Monte Carlo simulation, binomial trees, contingent claims analysis, and other financial engineering techniques, especially as it applies to valuing financial instruments (i.e. fixed income securities, swaps, exotic options, convertible bonds, commodity derivatives, and other securities.
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Exciting Employment Opportunity at MSK: We are seeking a Medical Laboratory Assistant to join our Specimen Processing Lab team! Exciting Employment Opportunity at MSK: We are seeking a Medical Laboratory Assistant to join our Specimen Processing Lab team.
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Supporting the development and implementation of a data strategy that enables current and future data processing, analytics and reporting requirements in alignment with the overall Pershing X’ data strategy and priorities.
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Position Summary : The Claim Examiner Trainee position is an entry-level position within liability Claims. Required to pass The Institutes Associate in Claims (AIC) 300; Claims in the Evolving World course/examination within 120 days from their date of hire as a requirement of and to continue in the Liability Claims Trainee Program.
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Knowledge and ability to use the following computer applications: Tableau, Power BI, ArcMap/ArcPro, ArcGIS Online, Adobe InDesign, and other data processing, visualization, and design tools. Related areas of technical focus for this position include but are not limited to vulnerability assessment, hazard mitigation, community planning, natural resource management, and research and planning related to Federal agencies (FEMA, USACE, NOAA, and USFWS), state agencies, and local communities.
$104,000 - $134,000 a yearFull-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Our history spans over 200 years and today we are a leader in investment banking, consumer and small business banking, commercial banking, financial transaction processing and asset management.
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AVP Claims - Allied Healthcare & MPL page is loaded. AVP Claims - Allied Healthcare & MPL. Expert knowledge of claims handling practices to include: coverage analysis, litigation management and negotiation.
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Physician Affiliate Group of New York (PAGNY) is comprised of nearly 3,000 physicians and healthcare professionals who provide services to NYC Health + Hospitals (H+H), the largest public health system in the United States.
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Must have experience with charge router, workqueue configuration, collection agency workflows, statement processing, facility structure, security, and credit card gateway. As a key member of the Information Technology Department, the Epic Analyst II will attain/maintain specialized knowledge of our enterprise Electronic Medical Record (EMR) software and serve as a vital liaison between the HSS IT Department, hospital departments, physician’s offices, and Epic representatives.
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Consult with business stakeholders to understand their needs and challenges, assess how AI techniques like machine learning, natural language processing etc. 7+ years experience architecting and developing AI or machine learning solutions on platforms such as AWS, Databricks, Azure, Google Cloud and OpenAI.
$140,000 - $307,000 a yearFull-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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The Sr. Food Scientist, Meat Applications is responsible for having a deep understanding of animal protein, animal protein processing, and animal protein applications. Must be able to provide in-depth technical support within the animal protein space and have deep fundamental knowledge of animal protein chemistry, microbiology, food safety and impact of various processes on finished products.
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The Sterile Processing Technician must have knowledge of surgical instrumentation and must be able to assemble surgical trays with a count sheet. The Sterile Processing Tech's are multi-skilled personnel who are responsible and accountable for all duties related to cleaning and decontamination of general and specialty surgical instruments, power equipment, endoscopes, and sterilization.
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claims processing examiner jobs in Jersey City, NJ
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