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The primary responsibilities, include but are not limited to, answering customer calls, proactively working to resolve our members and providers questions and concerns, responding to and documenting all customer encounters, intaking complaints, conducting outreach and retention efforts, assisting with PCP selections and handling all provider inquiries related to eligibility, claims and authorizations.
$45,879 a yearFull-timeExpandApply NowActive JobUpdated 3 months ago - UpvoteDownvoteShare Job
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Additionally, as of June 18, 2021, the duties and responsibilities of the former Office of the Gaming Inspector General were transferred to and encompassed by NYSIG, including the duty to receive and investigate complaints from any source concerning allegations of corruption, fraud, criminal activity, conflicts of interest or abuse in the Gaming Commission.
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Analyze and interpret complex data sets from multiple sources (claims, EMR, billing) to identify trends and insights that drive value-based care strategies. The ideal candidate will have a strong understanding in one of the following areas: ACOs, shared savings settlements, Medicare pricing, and or experience working with claims data.
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Filing of documents via NYSCEF in the various e-filing State courts (i.e. appaellate, court of claims, criminal, family, NYC civil, supreme civil, surrogate, and town/village court) and via NextGen CM/ECF is the various e-filing 94 district courts and 12 courts of appeals.
$65,000 - $75,000 a yearFull-timeExpandApply NowActive JobUpdated 1 month ago - UpvoteDownvoteShare Job
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As an Employee Relations Consultants you will be responsible for counseling on a wide range of employment-related matters, including negotiating employment terms for new hires, overseeing the performance management process, and advising on terminations, reductions-in-force, and business restructures alongside partnering with the Benefits Team to manage disability claims as they impact ongoing employment and the Rewards Team on executive compensation issues.
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We offer comprehensive design, construction management, and construction claims services, with expertise extending across a wide range of engineering disciplines, including civil, structural, and geotechnical engineering.
$55,670 - $91,563 a yearFull-timeExpandApply NowActive JobUpdated 22 days ago - UpvoteDownvoteShare Job
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You will be helping our clients and their counsel understand and resolve the financial impacts around their legal matters relating to complex accounting and financial issues across a wide range of projects involving economic disputes, claims, misunderstandings, investigations of white-collar crime, forensic accounting and consulting, and post-acquisition disputes often for companies in bankruptcy or in distress.
$100,000 - $140,000 a yearFull-timeExpandApply NowActive JobUpdated 3 months ago - UpvoteDownvoteShare Job
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We are seeking an experienced Actuarial Analyst to join our team and play a crucial role in developing and implementing value-based care strategies. Job Title: Actuarial Analyst (Value Based Care) Develop and maintain financial models to assess the impact of value-based care programs on healthcare outcomes and cost.
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Familiarity with some of the industry standard drafting and BIM software packages, including Autodesk suite (AutoCAD, Civil 3D, and REVIT), Bentley Microstation, Solidworks, and the production of structural details, drawings, and plans would be an advantage.
$55,670 - $91,563 a yearFull-timeExpandApply NowActive JobUpdated 21 days ago - UpvoteDownvoteShare Job
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Coordinating the Foundling’s response to any claim for unemployment benefits, in consultation with the VP-HR, HR Directors, HR Generalists, or Senior Generalist or HR Coordinator, or others; monitoring the Foundling’s results in connection with unemployment claims; managing the Foundling’s relationship with outside consultant for unemployment services.
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Job responsibilities Primary function is to investigate, evaluate and resolve new and existing high-profile complex claims, including: Concussion/CTE sports injury claims Toxic product exposures (Talc, benzene) Opioid public nuisance litigation claims PFAS groundwater contamination MTBE First and Third party Environmental Property damage and bodily injury exposure.
$105,000 - $132,000 a yearFull-timeExpandApply NowActive JobUpdated 3 days ago - UpvoteDownvoteShare Job
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Manage the Company's corporate insurance program, including enterprise risk management, program structuring and renewal, and certificates of insurance, as well as collaborating with other Legal & Business Affairs team members with claims reporting.
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Requires a progressive understanding of managed care business processes, data, systems, and applications for claims payment, enrollment, benefit design, product pricing, network and provider contracting, and utilization management.
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Prepare monthly, quarterly and annual claims, submit the claims and budgets to funders on various funder specific portals, including but not limited to HHS accelerator, e compass, VIPS, SMS, PMS, eLOCCs, Grants Gateway, etc.
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A leading claims management company providing claims administration, risk management, and loss control, underwriting, marketing, and client services in New York is adding a GL Claims Examiner to their growing team.
Full-timeExpandApply NowActive JobUpdated 10 days ago
claims complaints jobs Company: Metroplus Health Plan in Newark, NJ
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