- Sedgwick (Buffalo, 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...ideal candidate will have at least 2 years of claims handling experience, with a strong background in New… more
- Highmark Health (Buffalo, NY)
- …Experience: A minimum of 18 months of current consecutive experience as a Service Representative and/or Service/ Claims Representative at BC/BS of WNY, within ... responses to inquiries from internal and external customers; processes and adjusts claims . This is a bargaining unit position. The collective bargaining agreement… more
- New York State Civil Service (Buffalo, NY)
- …include, but are not limited to: Administrative Specialist 1, Investigator 2 (Compensation Claims ), Policyholder Services Representative 1, Claims Service ... previous loss and premium data* Experience rating data and claims material to price coverage* Defines, restricts, or qualifies...Representative 1, Claims Services Representative 1 (Disability Benefits); OR* A bachelor's or higher… more
- Liberty Home Care (Niagara Falls, NY)
- …before filling order(s). + Ensure all information/documentation required for billing claims to insurance provider(s) is collected and completed. Including but not ... limited to CMN's, prescriptions, and physician's orders. + Ensure accuracy and completeness of all documents. + Ensure ongoing documented communication with staff and referral source/client regarding progress of order processing and any related issues. + File… more
- Molina Healthcare (Buffalo, NY)
- …pharmacy prior authorization requests and/or appeals. + Explains Point of Sale claims adjudication, state, NCQA, and CMS policy/guidelines, and any other necessary ... information to providers, members, and pharmacies. + Assists with clerical services/tasks and other day-to-day operations as delegated. + Effectively communicates plan benefit information, including but not limited to, formulary information, copay amounts,… more
- Independent Health (Buffalo, NY)
- …clinical care management processes, member benefit structures and applications, and claims processing. + Knowledge of medical necessity criteria development, ... claims systems, clinical platforms and/or CRM applications. + Prior...team and others as designated as the HCS department representative . _Immigration or work visa sponsorship will not be… more
- CDM Smith (Buffalo, NY)
- …specialists when appropriate throughout the process. * Obtains the applicant representative 's agreement that all disaster-related damage was described and quantified ... projects and meets regularly on the status. * Evaluates applicant-provided cost claims for reasonableness to report to FEMA regarding claim eligibility. Participates… more
- NFTA (Buffalo, NY)
- …The list of essential functions, as outlined herein, is intended to be representative of the tasks performed within this classification. It is not necessarily ... customer support for employees, retirees and beneficiaries regarding benefit plans and claims issues. * Acts as Company liaison to representatives of health and… more
- M&T Bank (Buffalo, NY)
- …committees and other meetings, serving as the second line of defense representative in any discussions. Ensure the communication of relevant concerns or positions ... M&T Bank's insurance program, including monthly reporting, invoice processing, and claims management. Operational Risk Loss and Measurement: Ensures that the… more
- M&T Bank (Buffalo, NY)
- …committees and other meetings, serving as the second line of defense representative in any discussions. Ensure the communication of relevant concerns or positions ... M&T Bank's insurance program, including monthly reporting, invoice processing, and claims management. Operational Risk Loss and Measurement: Ensures that the… more