- Sedgwick (New York, NY)
- …place to work. Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Claims Examiner - Workers Compensation | NY License Are you looking ... Apply your knowledge and experience to adjudicate complex customer claims in the context of an energetic culture. +...PURPOSE OF THE ROLE:** To analyze high-level Workers Compensation claims on behalf of our valued clients to determine… more
- Brighton Health Plan Solutions, LLC (Westbury, NY)
- …The Role Brighton Health Plan Solutions (BHPS) is seeking an experienced Healthcare Claims Examiner skilled in the interpretation of Hospital and Ancillary ... Medical Policies and Payment procedures as well as capable of manually processing claims according to all outlined Policies and Procedures. This job description is… more
- Adecco US, Inc. (Melville, NY)
- _Are you a seasoned claims professional with a strong analytical mind?_ _Adecco's client is seeking a_ **_Workers' Compensation Claims Examiner_** _to join their ... USA._** **_What you'll do:_** . Investigate and analyze complex workers' compensation claims . . Negotiate settlements and manage litigation. . Manage claim reserves… more
- Amazon (New York, NY)
- …program around the world across all of its various use cases. Amazon's Last Mile Claims team is seeking a talented claims professional to support our rapidly ... auto program. You will lead strategy on complex bodily injury auto claims , handling pre-litigation disputes and resolving litigated claims with cross-functional… more
- Crawford & Company (Hauppauge, NY)
- …Touch Position Summary Investigate and settle advanced, large loss, complex claims promptly and equitably under minimal supervision. Works within established ... authority on moderate-to-difficult claims . Reviews coverages, determines liability and compensability, secures information, arranges property damage appraisals and… more
- Sedgwick (New York, NY)
- …training, and monitor individual claim activities; to provide technical/jurisdictional direction to examiner reports on claims adjudication; and to maintain a ... with management projects for the office. + Provides technical/jurisdictional direction to examiner reports on claims adjudication. + Compiles reviews and… more
- Crawford & Company (Hauppauge, NY)
- …supervises the investigation, management, and timely disposition of Workers Compensation claims within account, carrier and/or company guidelines, and assists the VP ... and/or Assistant VP of Claims in managing the Service Center. *Salary Range: USD...Reviews, analyzes, and assigns losses to the appropriate claim examiner with directives. Ensures all directives are executed appropriately.… more
- Akumin (New York, NY)
- …and state laws and regulations, including but not limited to: The False Claims Act, The Anti-Kickback Statute, The Civil Monetary Penalties Law, The Stark Law, ... (CIPP), Certified in Healthcare Privacy Compliance (CHPC), Certified Fraud Examiner (CFE), Certified Professional Compliance Officer (CPCO), or Certified… more
- Guidehouse (New York, NY)
- …datasets. + Analyze and interpret historical healthcare data related to claims , reimbursement, financial, clinical, and/or operations to identify risks, compliance ... agency. + Familiarity with case management tools. + Certified Fraud Examiner (CFE) or forensic accounting/financial investigations background. + Experience with… more
- City of New York (New York, NY)
- …of Health and Mental Hygiene (DOHMH) and the Office of the Chief Medical Examiner . The unit processes over 2,000 invoices a month which are received from vendors ... Duties and Responsibilities: - Perform internal audits, examination of expenditure claims to determine eligibility of costs reported. - Prepare claim verification… more