Claims jobs in Yonkers, New York - Page 3Create job alerts

A company is looking for a Claim Edit and Vendor Integrity Specialist.Key Responsibilities Apply coding knowledge to maintain and develop claim edits and partnerships Coordinate and resolve vendor needs while leading internal meetings and initiatives Research and clarify coding issues, and mento

A company is looking for a Patient Account Representative responsible for collections, account follow-up, and billing allowance posting.Key Responsibilities Follow up with payers to resolve outstanding claims and ensure timely billing Monitor and update patient and financial information for accur

A company is looking for a Claims Investigative Specialist. Key Responsibilities: Investigates all aspects of auto claims, including coverage, damages, and subrogation Applies understanding of insurance policies and organizational relationships Determines subrogation or fraud potential and colla

A company is looking for a Claims Examiner - Workers Compensation (REMOTE- Southeast State Experience).

A company is looking for a Senior Claims Adjuster Workers Compensation. Key Responsibilities Analyze claims exposure and execute decision-making to resolve claims effectively Communicate extensively with involved parties to ensure effective claim resolution Provide exceptional customer service t

A company is looking for a Senior Workers Compensation Claims Adjuster.Key Responsibilities Manage and resolve workers compensation claims by analyzing exposure and planning appropriate actions Communicate effectively with all parties involved in the claims process to ensure resolution Document

A company is looking for a Claims Adjuster, Workers Compensation.Key Responsibilities Independently manage all aspects of workers' compensation claims from initiation to closure Provide exceptional customer service and act as a point of contact for partner agents and customers Ensure compliance

Key Responsibilities Oversee behavioral health case management and ensure high-quality care for members Conduct medical necessity reviews for prior authorization and claims Integrate behavioral health interventions within physical health programs and supervise virtual services Required Qualific

Maintains established departmental policies and procedures, objectives, quality assurance program, safety, environmental, and infection control standards. Work ticklers assigned by Claims Management, Management Team and Self Pay teams for payor updates. Ability to plan and utilize time management sk

A company is looking for a Revenue Cycle Billing Specialist to collect on aging medical insurance claims.Key Responsibilities File claims using appropriate forms and attachments Research account denials and file written appeals as necessary Document all efforts in relevant computer systems and v

Key Responsibilities Collaborate with the Epic analyst team to provide developer-level support Optimize system performance by applying knowledge of hospital billing and claims applications Troubleshoot and resolve issues within the HB and Claims modules Required Qualifications Epic HB Certifi

Key Responsibilities Accurately enter new and refill orders while handling exceptions Adjudicate insurance claims and resolve rejections Communicate effectively with prescribers and caregivers to meet deadlines Required Qualifications Minimum one year experience in a retail or long-term care

Key Responsibilities Process and follow-up on billing for resident prescriptions, including understanding various insurance types Adjudicate insurance claims, troubleshoot rejected claims, and complete prior authorization forms Perform data entry and generate monthly statements while ensuring co

Key Responsibilities Analyze and audit inpatient claims, integrating medical coding principles and clinical guidelines Utilize proprietary auditing tools to make audit determinations and generate documentation Meet productivity and quality standards set by management while identifying potential

A company is looking for a Senior Workers Compensation Claims Adjuster for OH and WV.

A company is looking for a Senior Claims Adjuster Workers Compensation. Key Responsibilities Execute claims management decisions to analyze and resolve claims exposure Interact with various parties involved in the claim process to ensure effective communication and resolution Provide exceptional

Key Responsibilities Manage all aspects of workers' compensation medical only claims from set-up to closure Serve as a point of contact for partner agents and customers, providing claim guidance and status updates Proactively identify opportunities for claim mitigation and ensure compliance with

A company is looking for a Senior Auto and General Liability Claims Adjuster - Dedicated Client. Key Responsibilities Manage and resolve claims by analyzing exposure and planning appropriate actions Communicate effectively with all parties involved in the claims process to ensure resolution Docu

Key Responsibilities Prepare and analyze tax records, manage tax returns, and handle tax refund claims Maintain client relationships and identify business development opportunities Supervise and mentor tax professionals while contributing to departmental strategy Required Qualifications Bache

Key Responsibilities Maintain knowledge of DMEOPS CPT and ICD-10 codes to ensure accurate claims processing Utilize billing and collections systems to resolve unpaid, short paid, or denied claims Communicate effectively with insurance companies and internal partners regarding claims and accounts

A company is looking for a Liability Adjuster.Key Responsibilities Conduct investigations and evaluate coverage and liability Set and maintain reserves, negotiate settlements, and document claims Identify subrogation opportunities and mentor/train other staff Required Qualifications High scho

A company is looking for a Senior Customer Service Representative to provide support for healthcare-related inquiries and claims.Key Responsibilities Answer incoming calls from customers and assist with benefit, eligibility, and claims inquiries Review and research healthcare claims from provider

Performs follow-up on insurance billing and collection activities, verifying the accuracy and completeness of insurance records, and claims, contacting insurance companies, as well as, other related duties to expedite payments from various payers for physician services. Performs insurance follow-up

Key Responsibilities Serve as a subject matter expert for pharmacy COB processes and claims processing logic Analyze, monitor, and enhance processes and adjudication logic for pharmacy COB point-of-sale claims Lead projects related to process or logic changes across internal and external areas

A company is looking for a Director of Pharmacy. Key Responsibilities Oversee medical product management needs for pharmacy programs and establish key performance indicators Manage a team of pharmacists and oversee a nationwide prior authorization program for workers' compensation claims Analyze

A company is looking for a Claims Specialist in Massachusetts.Key Responsibilities Receives claims and confirms policy coverage and acknowledgment Determines validity and compensability of claims, establishing reserves and authorizing payments Manages non-complex claims and communicates status w

Key Responsibilities Supervise a Workers Compensation claims team to ensure high-quality service Promote best practices and guide the claims team in accordance with company standards Manage workloads, define team goals, and drive talent through hiring and training Required Qualifications High

A company is looking for a Claims Specialist.Key Responsibilities Process claims accurately and timely, adhering to established guidelines and standards Handle inquiries from customers and repair facilities, documenting detailed information for each claim Maintain good relationships with custome

A company is looking for an Unrepresented Bodily Injury Adjuster. Key Responsibilities Investigates and confirms facts of loss for complex automobile accidents Determines coverage, liability, and damages while adjusting and negotiating claims Mentors and provides direction to junior employees R

Key Responsibilities Gather, document, and validate business and technical requirements for pharmacy IT systems Analyze pharmacy claims processing logic and assist in system design and documentation Develop test plans and perform quality assurance for pharmacy-related system enhancements Requir

A company is looking for a Business Systems Analyst.Key Responsibilities: Collaborate with business partners to implement and migrate to the DomaniRx platform Utilize knowledge of pharmacy claims to identify and resolve defects and issues Develop and validate test cases to ensure successful migr

A company is looking for a Director, Call Center Operations.Key Responsibilities Oversee call center operations for member services, claims, prior authorizations, appeals, and provider support Achieve monthly SLAs and implement corrective action plans for performance gaps Manage telephony system

A company is looking for a Medical Billing Associate to manage revenue cycle functions and ensure accurate billing for virtual care services. Key Responsibilities Manage claims including follow-up, posting, appeals, and documentation requests Investigate and resolve denied claims by coordinating

Key Responsibilities Independently evaluates and documents findings from travel records and medical claims related to fraud, waste, and abuse with supervision Completes medical record reviews using knowledge of medical procedures and coding guidelines as assigned Prepares audit documentation and

Professional and Safe Work Environment As a member of the National Association of Spa Franchises, Hand and Stone has taken strives to reduce misconduct claims in the industry, promote professionalism and make massage therapy a safe, professional, and rewarding career. With over 13 modalities to spe

Summary: The primary objective of the Claims Management Specialist is to support Product Safety/Product Liability Department with operational activities including Direct Claim handling, customer contact & admin support, and overall claims management.The goal of the Claims Operations Specialist is to

A company is looking for a DBA Claims Specialist responsible for coordinating Defense Base Act claims processing and supporting successful claims resolution. Key Responsibilities Coordinates the research and flow of employment information for claim submission Builds collaborative relationships wi

Key Responsibilities Investigate and evaluate complex and litigated 3rd party claims under homeowners' insurance policies Manage litigation processes, including directing defense counsel and attending mediations and trials Negotiate settlements and maintain accurate claim documentation while ens

Key Responsibilities Register patients and verify insurance coverage Handle accounts receivable for Ambulatory Surgical Centers and submit appeals for denied claims Collect payments from patients and provide financial responsibility information Required Qualifications, Training, and Education

Under the direction of the Deputy Center Manager, with considerable latitude for decision making, performs difficult and responsible specialized administrative work supervising the functions of the City-wide Claims Units and/or supervising the functions of the City-wide Special Projects Units. A bac

Conducts focal healthcare medical claim audits on samples of processed transactions impacted by these updates/changes. Preferred Experience: 3+ years healthcare medical claims auditing.

Interstate Tractor Trailer Transportation Claims Resolution Specialist: Auto Physical and Property Damage. You can find the right exit ramp (pun intended) for the resolution of the claim that is in the insured's best interest. You have to want to know the whole story so you can make the right decisi

Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. Knowledge of the entire claims administrati

Job Description Job Overview of HR Generalist The Human Resources Generalist supports the daily operations of the HR department and plays a key role in ensuring compliance, accuracy, and quality service to employees and managers. This position is responsible for administering employee leaves, processing workers’ compensation claims, maintaining personnel files, conducting verification checks, and monitoring license compliance. The HR Generalist also prepares orientation materials, provides administrative and front desk support as needed, and serves as a point of contact for HR-related inquiries. Success in this role requires strong organizational skills, attention to detail, and the ability to handle sensitive information with professionalism and confidentiality. Essential Duties of HR Generalist • Provide day-to-day HR support to employees and managers., • Prepare orientation materials for new hire orientation., • File and maintain accurate, confidential paper and electronic personnel files., • Conduct employee verification checks as needed., • Administer and process all leave requests including Family and Medical Leave (FMLA), Paid Family Leave (PFL), Short-Term Disability (STD) and Long-Term Disability (LTD)., • Collect and track medical documentation for employees returning from leave., • Manage workers’ compensation claims, including incident reporting, claim filing, employee follow-up, and coordination with third-party insurance carriers to ensure proper processing and resolution., • Monitor and track employee driver’s license status, including NYS screenings through LENS and out-of-state records., • Ensure compliance with HR policies, procedures, and employment laws., • Provide receptionist and front desk coverage as needed to support daily operations., • Perform other related duties as assigned to support HR and organizational needs. Essential Qualifications of HR Generalist Key qualifications include: • Associate’s degree in human resources management, Business Administration, or a related field with at least 3 years of experience; or, • High school diploma with a minimum of 5 years of experience, • Years of experience must include 2 years of direct experience working in the human resources field required, • Natural interpersonal and communication skills, • Strong detail-oriented and resourceful mindset, • Knowledge of ADP Workforce Now, • Knowledge of HR federal laws and regulations with knowledge of leave laws. Benefits of HR Generalist • Generous PTO, 4 weeks of vacation, floating holidays, agency holidays, personal and sick time, • Health Insurance, • Dental Insurance, • Vision Benefits, • 401(k) Employer Contributions, • Tuition Reimbursement, • Flex Spending Accounts, • Employer Paid STD, LTD and Life Insurance, • Professional Development Physical/Travel Requirements of HR Generalist • Must have ability to reach, walk, sit, climb stairs, bend, lift 20lbs and have visual acuity (with correction as needed), and auditory acuity (with correction as needed)., • Valid driver’s license is preferred. Working Conditions of HR Generalist • Standard schedule: Monday to Friday, 9:00 AM – 5:00 PM (35 hours per week), • Flexibility to work an 8:00 AM – 4:00 PM shift as needed The employee must be able to meet these requirements with or without reasonable accommodation. Disclaimer Nothing in this job description restricts Andrus’ right to modify the duties/responsibilities of this job at any time, with or without advanced notice. EEO Statement Andrus is an equal opportunity employer.

Job DescriptionBenefits: • 401(k) matching, • Bonus based on performance, • Competitive salary, • Opportunity for advancement 1. Demonstrate and communicate the core values of CareTen, Inc., 5. Successfully oversee and manage all service and employment related content made to the office after normal business hours as necessary.

Job DescriptionBenefits: Are you a high school student (junior or senior preferred) interested in dentistry, healthcare, or office work? Wed love to meet you! Our well-established dental office in Fort Lee, NJ is looking for a reliable, detail-oriented student to support our front desk and insurance follow-up process. This is a part-time paid position that also offers a great opportunity to learn how a dental office runs behind the scenes. Youll work closely with our office manager and front desk team in a supportive, real-world environment. Responsibilities: • Enter and track insurance claims using our office software, • Check online insurance portals for claim updates, • Call insurance companies to verify claim status, • Assist with scanning, organizing, and filing paperwork, • Support other front desk follow-up tasks as neededThe ideal candidate is:, • Organized, dependable, and detail-oriented, • Comfortable using computers (Windows + Google Sheets), • Interested in healthcare or dental fields, • Available 23 weekdays after school, • Lives nearby (Fort Lee High School students strongly encouraged to apply!)Plus:, • Gain experience with real-world dental office systems, • To show you excel at details: in the last question about if there's anything you'd like us to know about you, include the phrase Ready to help in your answer., • Possible opportunity to shadow dental procedures or assist with basic clinical dental tasksWhether youre looking to explore the dental field or gain professional experience after school, were excited to hear from you!

Pending Claim Management, KPI & TAT Management – Claim registration to closure Product Verification Liability Assessment by reviewing diagnosis results Reporting on high-profile claims to the leadership Qualifications: 3-5 years of hands-on claims management & customer care experience Expertise in

Newsweek Recognizes Sedgwick as America's Greatest Workplaces National Top Companies Certified as a Great Place to Work Fortune Best Workplaces in Financial Services & Insurance Aviation Claims Surveyor Job Locations: Singapore / Miami / Latin America Job Type: Permanent Remuneration: Competit