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You will work collaboratively across business units including but not limited to; claims, finance, risk engineering, actuary, and technical underwriting while gaining extensive knowledge in a growing and innovative industry.
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Processes workers compensation claims and conducts the preliminary investigations. This position will have both administrative and strategic responsibilities when it comes to planning, implementing, and maintaining HR programs, policies, and procedures including but not limited to, benefits administration, employee, and labor relations, leave of absence management, workers compensation, talent acquisition and compensation, within the New York office and throughout the enterprise.
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As a Retail Administrative Assistant you will: Assist managers with store reporting, recordkeeping maintenance, claims documentation, program results records, etc. Monitor the store communication systems, ensure that communications are appropriately disseminated, and track the activities related to store assignments; Assist with scheduling, timekeeping, and payroll administration under the guidance of managers; Oversee employee records and files; includes time & attendance records, employment documentation, etc.
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Ready to take your passion for sports to the next level? Join Dick's Sporting Goods in their mission to become the ultimate destination for athletes and sports enthusiasts.
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Litigation management of Cyber and Technology Errors and Omissions (E&O) liability claims including: retention of counsel, strategy planning and analysis that may include alternate dispute resolution, direct negotiations and/or trial management.
Full-timeExpandApply NowActive JobUpdated 12 days ago - UpvoteDownvoteShare Job
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Wright Public Entity serves as a management company providing claims administration, risk management & loss control, underwriting & marketing, and client services in New York for the NY Schools Insurance Reciprocal (NYSIR: ‘A’ rated by Best), NY Municipal Insurance Reciprocal (NYMIR: ‘’ rated by Best) and Statewide Schools Health Plan. We also act as a TPA for Workers Compensation for various self-insured schools & municipalities in New York.
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Check and process reinsurance accounts and claims advice (OMEGA) The Portfolio Manager will oversee the Alternative Solutions and MGA administration of reinsurance and insurance accounts and contracts.
$95,000 - $115,000 a yearFull-timeExpandApply NowActive JobUpdated 2 days ago - UpvoteDownvoteShare Job
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Please consider joining our team by sending your credentials to AttorneyRecruiting@wilsonelser.com and putting "NYC Claims Management & Coverage Counsel" in the subject line. Wilson Elser is currently seeking Attorneys with Claims Management & Coverage Counsel experience.
$105,000 - $160,000 a yearFull-timeExpandApply NowActive JobUpdated 3 days ago - UpvoteDownvoteShare Job
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MetroPlus Health Plan 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, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, 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 - UpvoteDownvoteShare Job
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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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Our data scientists are knowledgeable about medical claims data and the risk-adjustment models that determine our revenues; analyze opportunities for cost saving strategies; forecast future expenditures; identify patterns of utilization among service providers, member cohorts and longitudinally over our member’s continuum of care.
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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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Serves as a resource/consultant to customers and Horizon staff regarding local, regional and national payer policies, reimbursement regulations and processes (i.e., eligibility and benefit verification, prior-authorization, billing, coding, claims, and appeals/denials), Medicare and Medicaid rules and regulations, and OSHA and HIPAA compliance as related to Horizon products.
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Strong knowledge of key laws and regulations impacting the pharmaceutical industry including the PhRMA Code; Federal Food, Drug, Cosmetic Act; Anti-Kickback Statute; False Claims Act, OIG/DOJ Guidance; Foreign Corrupt Practices Act; and federal and state transparency and disclosure laws.
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claims job Company: Metroplus Health Plan in Newark, NJ
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