NewBusiness Data Analyst P&C Insurance iShare IncBusiness Data Analyst P&C InsuranceJersey city, NJFull timeThis role requires close collaboration with business stakeholders, subject-matter experts, data engineers, developers, and data modelers to ensure data accuracy, consistency, and alignment with policy and claims processes. We are seeking an experienced Business Data Analyst to support large-scale enterprise data initiatives within the Property and Casualty (P&C) Insurance domain.
NewRisk Adjustment Coding Specialist VNS HealthRisk Adjustment Coding SpecialistNew York, New York$33.88–$42.35 / hourFull timeMinimum two years of payor work experience with medical records, including ICD-10-CM or current coding system and medical record systems required Working knowledge of medical terminology, provider reimbursement, ICD-10, HCPCS and CPT-4 coding, coordination of benefits required Additional years of experience/specialized certification/training may be considered in lieu of educational requirements required Knowledge of medical terminology, physiology, pharmacology, and disease processes and related procedures required Strong knowledge of claims processing procedures and systems, State, Federal and Medicare Regulations and Coordination of Benefits applications required Strong planning, organizational, interpersonal, verbal and written communication skills required Must be PC literate and possess a strong understanding of Microsoft applications required Ability to handle multiple priorities and meet deadlines required Knowledge of HIPAA, understanding a commitment to Privacy, Security and Confidentiality of all medical chart documentation required Ability to work both in a fast-paced environment and/or be independently self-driven to complete day to day tasks required Ability to switch gears and independently collaborate with other departments for all ad lib projects as necessary required. Provider Engagement, Audit, Training and Support and supports supervisor in preparing internal presentations, knowledge libraries, coding guidelines, and summary reports of coding review for department infrastructure, maintains professional communication with provider engagement team by assisting with analysis, trending, and presentation of audit/review findings, outcomes, and issues.
Director, No Fault Metropolitan Transportation AuthorityDirector, No FaultBrooklyn, NY$119,295–$149,119 / yearOpening: The Metropolitan Transportation Authority is North America's largest transportation network, serving a population of 15.3 million people across a 5,000-square-mile travel area surrounding New York City, Long Island, southeastern New York State, and Connecticut. Job Summary: This position manages the MTA Law Department's No-Fault Unit, which handles all aspects of administration, litigation, and payment of No-Fault claims made against the MTA, New York City Transit, and their affiliates and/or subsidiaries in compliance with applicable New York law and regulations.
Director, Payment Integrity Capital Rx, Inc.Director, Payment IntegrityNew York, NY$206,400–$258,000 / yearPosition Summary: The Director, Payment Integrity will build and lead Judi Health's payment integrity program from inception, establishing the infrastructure, processes, and team that will ensure claims are paid correctly, compliantly, and efficiently across our commercial plan population. By delivering true price transparency, eliminating unnecessary middleman fees, and leveraging advanced AI-powered care delivery, Judi Health helps clients achieve unprecedented operational efficiency and service levels.
NewSubrogation Collections Negotiator Element Fleet Management CorpSubrogation Collections NegotiatorNY$60,400–$83,050 / yearActual compensation will be determined based on several factors, including the successful candidate's qualifications, knowledge, skills, experience, internal pay equity, and relevant market data. Ability to demonstrate empathy, consideration of our customers public image, and industry knowledge while exhibiting strong negotiation capabilities to generate maximum recovery.
NewSenior Director, Product, Care Foundations Spring Care IncSenior Director, Product, Care FoundationsNew York, NY$245,000–$328,000 / yearWith outcomes independently validated by JAMA Network Open and the Validation Institute, Spring Health reaches more than 170 million people worldwide through leading employers, health plans, and partners. Build strong cross-functional partnerships with leaders across Engineering, Design, Clinical Operations, Revenue Operations, and Finance to ensure operational readiness and alignment.
Sr Program Dir - Hudson Program Comm Strategy & Dev - 90377183 - New York (New York, NY, US, 10119) AmtrakSr Program Dir - Hudson Program Comm Strategy & Dev - 90377183 - New York (New York, NY, US, 10119)New York, NY$187,500–$242,892 / hourThis position will also conduct outreach, coordination and collaboration with Amtrak departments, the Federal Transit Administration, Federal Railroad Administration, Gateway Development Commission, Port Authority of New York & New Jersey, NJ TRANSIT, States and localities, commuter and freight operators, and suppliers, other third parties, investors and stakeholders to develop strategies, plans, funding and finance approaches, and partnerships to advance Amtrak’s mission. This position will direct project execution teams to ensure projects deliver high-quality assets safely and effectively, as well as ensuring the Program stays within the approved scope, schedule, and budget, and ensure that adequate and timely support is obtained from other functions.
Senior Technical Trainer - (Enterprise Solutions) Capital Rx, Inc.Senior Technical Trainer - (Enterprise Solutions)New York, NY$98,400–$123,000 / yearJudi Health is an enterprise health technology company providing a comprehensive suite of solutions for employers and health plans, including: Judi Rx, a public benefit corporation delivering full-service pharmacy benefit management (PBM) solutions to self-insured employers, Judi Health, which offers full-service health benefit management solutions to employers, TPAs, and health plans, and. Develop and maintain engaging and effective technical training materials and resources (including user guides, job aids, video content, eLearning modules, and SOPs) that enable users to successfully navigate and utilize the Unified Claims Processing platform.
Procedural Billing Specialist II-MSW-FT Days Mount Sinai Health SystemProcedural Billing Specialist II-MSW-FT DaysNew York, NY$59,895–$89,843 / yearWe are consistently ranked by U.S. News & World Report's Best Hospitals, receiving high "Honor Roll" status, and are highly ranked: No. 1 in Geriatrics, top 5 in Cardiology/Heart Surgery, and top 20 in Diabetes/Endocrinology, Gastroenterology/GI Surgery, Neurology/Neurosurgery, Orthopedics, Pulmonology/Lung Surgery, Rehabilitation, and Urology. Mount Sinai advances health for all people, everywhere, by taking on the most complex health care challenges of our time - discovering and applying new scientific learning and knowledge; developing safer, more effective treatments; educating the next generation of medical leaders and innovators; and supporting local communities by delivering high-quality care to all who need it.
Soarian Financials (SF) Principal Consultant Oracle CorpSoarian Financials (SF) Principal ConsultantNew York, NY$29.42–$63.65 / hourOngoing Services include Solution Architect which includes working in conjunction with Cerner Client Alignment Executive, Upgrade Center Team, AMS and when applicable, the contract management and recovery services (CMARS) team to provide ongoing services to support and maintain the Billing System. Service Requests: These are requests for support or changes to be made to the Billing System in the following categories: Incident: An unplanned disruption in system or business operations either reported by OMH users, found by the Vendor's staff, or uncovered by the Vendor's monitoring tools.
Adjuster Supervisor Pactiv Evergreen IncAdjuster SupervisorElizabeth, NJ$22–$25 / hourPrograms include company and industry training curricula, support for formal education through the Tuition Reimbursement Program (Non-Union), and a Learning Management System that supports and enhances employee skills at all levels of the organization. Novolex is a leading manufacturer of food, beverage, and specialty packaging that supports multiple industries including foodservice, restaurant delivery and carryout, food processing, grocery and retail, and industrial sectors.
NewBusiness Data Analyst P&C Insurance iShareBusiness Data Analyst P&C InsuranceJersey city, New JerseyiShare was founded to fill a real market need – with so much noise about cloud, big data, and information security, companies today are adopting software product after product and losing sight of which they need and why, while what they really need is credible consulting that takes the time to understand their company’s unique scenario and requirement, and then architect a solution accordingly. This role requires close collaboration with business stakeholders, subject-matter experts, data engineers, developers, and data modelers to ensure data accuracy, consistency, and alignment with policy and claims processes.
Assistant Insurance Fund Services Representative New York State Thruway AuthorityAssistant Insurance Fund Services RepresentativeNew York, NY$57,413–$69,061 / yearEligible titles include, but aren't limited to: Administrative Assistant 1, Business Services Center Representative 1, Payroll Specialist 1, Program Aide, Taxpayer Services Rep 1, Payroll Examiner 1. About NYSIF: For more information about NYSIF, including our mission, commitment to diversity, equity, and inclusion, and efforts to fulfill Executive Order 31, please visit www.nysif.com.
Senior Project Manager Capital Rx, Inc.Senior Project ManagerNew York, NY$117,600–$147,000 / yearInteract daily with product manager and scrum teams with effective and efficient communications to ensure proper tracking of project roadmap and hold all project team members accountable for accurate and timely completion of assigned tasks. By delivering true price transparency, eliminating unnecessary middleman fees, and leveraging advanced AI-powered care delivery, Judi Health helps clients achieve unprecedented operational efficiency and service levels.
Associate Director, Client Services - Account Management Capital Rx, Inc.Associate Director, Client Services - Account ManagementNew York, NY$163,600–$204,500 / yearPosition Overview: The Associate Director, Account Management is responsible for managing the planning, execution, issue resolution and day to day account management functions of an assigned high profile and limited client portfolio and team to ensure ongoing client satisfaction in the Pharmacy Benefit Management (PBM) market segment including Health Systems, Employer Groups, Public Entities, Labor/Union and Small Market. By delivering true price transparency, eliminating unnecessary middleman fees, and leveraging advanced AI-powered care delivery, Judi Health helps clients achieve unprecedented operational efficiency and service levels.
Customer Service Representative Brighton Health Plan Solutions, LLCCustomer Service RepresentativeNew York, NY$40,560–$47,840 / yearBrighton Health Plan Solutions partners with self-insured employers, Taft-Hartley Trusts, health systems, providers as well as other TPAs, and enables them to solve the problems facing today’s healthcare with our flexible and cutting-edge third-party administration services. The Customer Service Representative assists members, physicians, hospitals, revenue agencies and other healthcare providers with member benefits, eligibility, claims inquiry, claim reconsiderations and appeals.
Customer Service Representative/ Bilingual (Spanish) Brighton Health Plan Solutions, LLCCustomer Service Representative/ Bilingual (Spanish)New York, NY$45,760–$47,840 / yearBrighton Health Plan Solutions partners with self-insured employers, Taft-Hartley Trusts, health systems, providers as well as other TPAs, and enables them to solve the problems facing today’s healthcare with our flexible and cutting-edge third-party administration services. About The Role The Customer Service Representative, Bilingual, assists members, physicians, hospitals, revenue agencies and other healthcare providers with member benefits, eligibility, claims inquiry, claim reconsiderations and appeals.
Construction Field Investigator GallagherConstruction Field InvestigatorPleasantville, New York$28–$35 / hourFull timeAs a Construction Field Investigator, you will conduct on-site investigations, gather and analyze evidence, interview witnesses, document accident scenes, and prepare detailed reports that help clients determine the facts surrounding construction incidents and claims. Unlike traditional investigator positions, this role provides the opportunity to develop expertise in construction-related claims and losses while supporting some of the nation's largest contractors, insurance carriers, and risk management programs.
NewSenior Director, Product, Care Foundations Spring HealthSenior Director, Product, Care FoundationsNew York, NY$245,000–$328,000 / yearWith outcomes independently validated by JAMA Network Open and the Validation Institute, Spring Health reaches more than 170 million people worldwide through leading employers, health plans, and partners. Build strong cross-functional partnerships with leaders across Engineering, Design, Clinical Operations, Revenue Operations, and Finance to ensure operational readiness and alignment.
Personal Lines Customer Service Representative Bilingual Spanish Sumra AgencyPersonal Lines Customer Service Representative Bilingual SpanishNorwalk, ConnecticutJob Description The Personal Lines CSR at Sumra Agency Inc - All State Insurance Company is responsible for maintaining solid customer relationships by handling personal lines insurance coverage inquiries and concerns with speed and professionalism through daily interaction with customers, insurance carriers, and fellow employees while conducting specific service and marketing activities. Resolve product or service issues by clarifying the customer's concern, determining the cause of the issue, selecting and explaining the best solution to solve the issue, expediting correction or adjustment, following up to ensure resolution.