• Workers Compensation Claims

    Sedgwick (Albany, NY)
    …Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Workers Compensation Claims Representative | Remote | NY Licensing Required ... **PRIMARY PURPOSE** **:** To analyze mid- and higher-level workers compensation claims to determine benefits due; to ensure ongoing adjudication of claims within… more
    Sedgwick (12/12/24)
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  • Liability Claims Representative

    Sedgwick (Albany, NY)
    …to work. Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Liability Claims Representative | Remote Are you looking for an ... Apply your knowledge and experience to adjudicate complex customer claims in the context of an energetic culture. +...OF THE ROLE:** To analyze mid-level Commercial General Liability claims on behalf of our valued clients to determine… more
    Sedgwick (10/31/24)
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  • Claims Representative I…

    Ryder System (Albany, NY)
    …small to medium 3rd party property damage and cargo claims under Ryder's self-insured, self-administered liability program. **ESSENTIAL FUNCTIONS** Investigates, ... to medium exposure 3rd party property damage and cargo claims pursued against Ryder Ensures the most appropriate and...to verify the legitimacy of an interview or Ryder representative , please contact Ryder at ###@ryder.com or ###. **Current… more
    Ryder System (01/15/25)
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  • Workers Compensation Claims

    Sedgwick (Albany, NY)
    …Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Workers Compensation Claims Representative | NY Jurisdiction | Dedicated Client We are ... seeking a highly motivated and experienced Workers' Compensation Claims Representatives to join our team. The ideal candidate will have at least 2 years of claims more
    Sedgwick (10/18/24)
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  • Claims Representative I (Health…

    Elevance Health (Latham, NY)
    **Title: Claims Representative I (Health & Dental) - FEP** **Location:** This position will work a **hybrid model ( remote and office)** . The ideal candidate ... the first 12 weeks of training. Start date: 3/10/2025.** The ** Claims Representative I** will be responsible for successfully completing the required basic… more
    Elevance Health (01/11/25)
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  • Utilization Management Representative I

    Elevance Health (Latham, NY)
    Job Description **Title: Utilization Management Representative I** **Location:** This position will work a hybrid model ( remote and office). Ideal candidates ... 50 miles of one of our PulsePoint locations. The **Utilization Management Representative I** will be responsible for coordinating cases for precertification and… more
    Elevance Health (01/15/25)
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  • Director, Senior Counsel, Regulatory & Compliance…

    United Therapeutics (Albany, NY)
    …the pharmaceutical and biotech industry, including FDA advertising and promotion, False Claims Act, Anti-Kickback Statute, OIG Guidance, the PhRMA Code, the Sunshine ... to the Food Drug and Cosmetic Act, the False Claims Act, Anti-Kickback Statute, the Sunshine Act and other...healthcare related laws and regulations + Serve as Legal representative on the Company's promotional review committee, including review… more
    United Therapeutics (12/14/24)
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  • Senior Manager, Product Operations

    HealthEdge Software Inc (Albany, NY)
    …and QE. We have divided our product teams into Value Streams (ie, Claims , Billing & Financials, Enrollment, BlueCard, Integration, and Platform). Each Value Stream ... integrated solutions suite includes the industry's leading, digital, next-generation claims administration processing system, business intelligence, integration capabilities, a… more
    HealthEdge Software Inc (12/20/24)
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  • Business Consultant

    HealthEdge Software Inc (Albany, NY)
    …issues are identified and addressed upstream, and all aspects of claims operations are centralized for comprehensive business intelligence. The complete suite ... of provider rate and/or claim editing provisions in a claims adjudication system and/or third-party vendor application. + Working...None **Work Environment:** The physical demands described here are representative of those that must be met by an… more
    HealthEdge Software Inc (12/18/24)
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  • Network Engineer

    HealthEdge Software Inc (Albany, NY)
    …root-cause issues areidentifiedand addressed upstream, and all aspects of claims operations are centralized for comprehensive business intelligence. The complete ... and deliver excellent software and services to our customers._ **Geographic Responsibility:** Remote but ideal candidate would live within the driving distance to… more
    HealthEdge Software Inc (11/27/24)
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  • Senior Principal QA Architect

    HealthEdge Software Inc (Albany, NY)
    …solutions suite includes the industry's leading, digital, next-generation claims administration processing system, business intelligence, integration capabilities, a ... permanent **Work Environment:** The physical demands described here are representative of those that must be met by an...Work across multiple time zones in a hybrid or remote work environment. + Long periods of time sitting… more
    HealthEdge Software Inc (11/20/24)
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  • Utilization Management Reprsentative II

    Elevance Health (Latham, NY)
    **Title: Utilization Management Representative II** **Location:** This position will work a hybrid model ( remote and office). Ideal candidates will live within ... 50 miles of one of our PulsePoint locations. The **Utilization Management Representative II** will be responsible for managing incoming calls, including triage,… more
    Elevance Health (01/15/25)
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  • Manager, Fraud and Waste * Special Investigations…

    Humana (Albany, NY)
    …managed care organizations, as well as state and federal employees. **WORK STYLE:** Remote /work at home with Up to 10-15% travel (local, regional, national) will be ... investigation experience in managed care or CMS. + Prior health insurance claims experience + Demonstrated formal or informal people management + Excellent PC… more
    Humana (12/19/24)
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