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cyber claims officer

Liberty Mutual Insurance

<div><b>Description
</b><div><p>In today's rapidly evolving cyber landscape, our insureds face increasingly complex threats from ransomware and business email compromise to large‑scale data breaches. As a <b>Cyber Claim Officer</b>, you will manage high‑exposure, often time‑sensitive matters, working closely with breach coaches, forensic investigators, underwriters, actuaries and cybersecurity experts. You will play a critical role in helping organizations respond to emergent cyber incidents and privacy, media and technology errors &amp; omissions litigation, ensuring a confident and coordinated response, and shaping best practices in our cyber claims strategy. This is a high‑impact opportunity for someone who thrives on novel issues, technical complexity, fast‑moving incidents, and collaborative problem‑solving.</p><p></p><p><b><br>
Responsibilities</b></p><ul><li>
Analyzes, investigates, and evaluates cyber, media and technology‑related losses to determine coverage, exposure, and appropriate claim disposition.</li><li>
Utilizes CMS to document claims, track activity, and maintain accurate diary follow‑ups.</li><li>
Establishes and monitors indemnity and expense reserves within assigned authority, ensuring accuracy and adequacy throughout the claim lifecycle.</li><li>
Makes recommendations for reserves on claims outside of authority level.</li><li>
Prepares clear and comprehensive reports for management, underwriting, and other stakeholders.</li><li>
Identifies and communicates emerging cyber‑specific claim trends, threat vectors, and policy issues to management and underwriting.</li><li>
Manages litigation involving cyber, media, privacy, and technology‑related matters through strategic oversight of counsel.</li><li>
Adheres to line‑of‑business litigation guidelines, including budgeting, bill review, and payment processing.</li><li>
Proactively manages the full claim lifecycle from first notice through resolution, ensuring timely, strategic progression.</li><li>
Actively participates in mediations, arbitrations, and settlement negotiations within assigned settlement authority.</li><li>
Participates in internal and external claims audit processes.</li><li>
Provides claims‑focused marketing support by meeting with brokers, risk managers, and reinsurers.</li><li>
Maintains required adjuster licenses across jurisdictions.</li></ul><p><b>
Additional Cyber‑Specific Responsibilities Added:</b></p><ul><li>
Coordinates incident response activities with breach coaches, forensic firms, crisis‑communications teams, and cybersecurity vendors during active cyber events.</li><li>
Evaluates forensic findings (e.g., Digital Forensics and Incident Response (DFIR), Forensic Accounting) and integrates conclusions into coverage and liability decisions.</li><li>
Advises insureds on recovery strategies, including business interruption documentation, data restoration processes, and post‑incident cyber‑hygiene improvements.</li><li>
Engages in thought leadership such as panel presentations, white papers, conference attendance, etc.</li></ul><p></p><p><b><br>
You will be required to go into the office twice a month if you reside within 50 miles of one of the following offices: Westborough, MA; Boston, MA; Hoffman Estates, IL; Indianapolis, IN; Lake Oswego, OR; Chandler, AZ; Las Vegas, NV; Plano, TX; or Suwanee, GA. Please note this policy is subject to change</b></p></div><b>
Qualifications</b><div><ul><li>
Bachelors' and/or advanced degree</li><li>
10 + years claims experience, with at least 5 years within a technical specialty</li><li>
Highly advanced knowledge of claims handling concepts, practices and techniques, to include but not limited to coverage issues, and product line knowledge</li><li>
Functional knowledge of law and insurance regulations in various jurisdictions</li><li>
Demonstrated superior verbal and written communications skills</li><li>
Highest level of advanced analytical, decision making and negotiation skills</li></ul></div><b>
About Us</b><p><b>
Pay Philosophy:</b> The typical starting salary range for this role is determined by a number of factors including skills, experience, education, certifications and location. The full salary range for this role reflects the competitive labor market value for all employees in these positions across the national market and provides an opportunity to progress as employees grow and develop within the role. Some roles at Liberty Mutual have a corresponding compensation plan which may include commission and/or bonus earnings at rates that vary based on multiple factors set forth in the compensation plan for the role.<br>
<br>
At Liberty Mutual, our goal is to create a workplace where everyone feels valued, supported, and can thrive. We build an environment that welcomes a wide range of perspectives and experiences, with inclusion embedded in every aspect of our culture and reflected in everyday interactions. This comes to life through comprehensive benefits, workplace flexibility, professional development opportunities, and a host of opportunities provided through our Employee Resource Groups. Each employee plays a role in creating our inclusive culture, which supports every individual to do their best work. Together, we cultivate a community where everyone can make a meaningful impact for our business, our customers, and the communities we serve.<br>
<br>
We value your hard work, integrity and commitment to make things better, and we put people first by offering you benefits that support your life and well-being. To learn more about our benefit offerings please visit: https://LMI.co/Benefits<br>
<br>
Liberty Mutual is an equal opportunity employer. We will not tolerate discrimination on the basis of race, color, national origin, sex, sexual orientation, gender identity, religion, age, disability, veteran's status, pregnancy, genetic information or on any basis prohibited by federal, state or local law.<br>
<br>
<b>Fair Chance Notices</b></p><ul><li>
California</li><li>
Los Angeles Incorporated</li><li>
Los Angeles Unincorporated</li><li>
Philadelphia</li><li>
San Francisco</li></ul></div>

Cyber Claims Officer

YMCA

<div><div><div>The Harlem YMCA is seeking a Business Office HR Coordinator.
</div><div><div>Job Description
</div><div><p><b>Salary: $22.50 Hourly
</b></p><p>The Harlem YMCA is seeking a Business Office HR Coordinator. Under the supervision of the Business Manager, the Business Office HR Coordinator will provide daily Human Resources and Payroll support, as well as support in some areas of Financial Business.
</p><p><b>Benefits:
</b><br>
The YMCA of Greater New York offers a variety of benefits to its staff members, including retirement benefits , medical, paid time off, free YMCA membership, and more! Benefit eligibility is determined by an individual&rsquo;s employment status (i.e., full-time or part-time), tenure, and/or the number of hours scheduled to work. Click here for more information.
</p><p><b>How to Apply:
</b><br>
If you would like to be a member of our dynamic team, please complete our online application and submit your r&eacute;sum&eacute; and a thoughtful cover letter that explains your interest in the role and our organization.
</p></div></div><div><div>Qualifications
</div><div><ul><li>Bachelor&rsquo;s Degree or equivalent work experience required.
</li><li>One (1) to two (2) years of experience in bookkeeping and/or administrative assistance. Knowledge of Human Resources preferred.
</li><li>Strong computer skills. Knowledge of HRIS is a plus.
</li><li>Detail-oriented and can manage multiple projects simultaneously.
</li><li>Must be able to handle a high volume of work.
</li><li>Excellent customer service and communication skills.
</li></ul></div></div><div><div>Essential Functions<br>
</div><div><p><br>
<b>Human Resources Responsibilities
</b></p><p>Responsible for the processing of employment and volunteer documents in a timely manner, including, but not limited to:
</p><ul><li>Entry of employee and volunteer screenings into the applicable system.
</li><li>Assist with Youth &amp; Family screening and agency processing.
</li><li>Assist with conducting new hire orientations/paperwork reviews with new or rehired staff (i.e., Benefit PowerPoint, paperwork, etc.).
</li><li>Generate and maintain the supply of New Hire Packets, Status Change forms, etc.
</li><li>Data entry into CONNECT: HR is completed timely and accurately.
</li><li>Assist with the maintenance and accurate filing of all employee and volunteer files.
</li></ul><p>Will assist the supervisor to ensure appropriate staff/agencies are notified within the required timeframe regarding the following, but not limited to:
</p><ul><li>Assist with leave requests, including FMLA, disability, paid family leave, personal leave, etc.
</li><li>Help coordinate medical plan changes, providing staff with benefit summaries and information.
</li><li>Provide an overview of health insurance, retirement, direct deposit, etc.
</li><li>Provide vacation hours, sick hours, and personal benefits upon request.
</li><li>Assist with employment verification requests.
</li><li>Timely response to unemployment claims in the absence of the supervisor.
</li><li>Timely entry of Workers Comp claims in the absence of the supervisor.
</li></ul><p>Will assist with tracking training completions for all branch staff to ensure compliance, including, but not limited to, Praesidium Academy Child Abuse Prevention, Preventing Sexual Harassment, Cyber Security Awareness, Active Assailant, Time-Clock Use, etc.
</p><p><b>Financial Responsibilities
</b></p><ul><li>Assist in preparing the branch's daily deposits, bank and credit card reconciliation, and reporting. Resolve and track chargebacks.
</li><li>Assist in processing accounts payable vouchers and invoices, reconciling with the Accounts Payable system, and updating AP &amp; PO tracking reports. Run open PO and Income-On-Hold (IOH) reports to notify branch staff.
</li><li>Assist in handling petty cash flow, auditing receipts, and preparing Accounts Payable reimbursement vouchers.
</li><li>Assist in collecting purchasing card documents and submitting them to the Association Office (AO).
</li><li>Assist in the distribution of financial reports to all branch department heads.
</li><li>Maintain and update the branch's business office records, including vendor files and business office archives, in accordance with the File Retention guidelines.
</li><li>Assist in government contract record keeping and reporting to the agency in a timely manner.
</li></ul><p><b>Other Responsibilities
</b></p><ul><li>Act as a backup for the branch's Administrative Assistants (i.e., assisting department heads, distributing mail, etc.).
</li><li>Assist the branch with maintaining all office equipment and computers, and ordering and managing equipment supplies. Help to create and submit HelpDesk tickets.
</li><li>Order and manage the inventory of the branch's office supplies.</li></ul></div></div></div></div>

Business Office HR Coordinator

Columbia University

<div><ul><li>Job Type: Officer of Administration</li>
<li>Bargaining Unit:</li>
<li>Regular/Temporary: Regular</li>
<li>End Date if Temporary:</li>
<li>Hours Per Week: 35</li>
<li>Standard Work Schedule: Monday - Friday</li>
<li>Building: PH-20</li>
<li>Salary Range: 160,000 - 180,000</li>
</ul><div><i>The salary of the finalist selected for this role will be set based on a variety of factors, including but not limited to departmental budgets, qualifications, experience, education, licenses, specialty, and training. The above hiring range represents the University's good faith and reasonable estimate of the range of possible compensation at the time of posting.</i></div><br>
<div></div>
<p></p>
<p>Position Summary</p>
<p>
The Department of Biomedical Informatics at Columbia University is seeking a highly motivated data science engineer to support large-scale observational research within the OHDSI (Observational Health Data Sciences and Informatics) network. This role will focus on the design, implementation, and execution of distributed network studies using electronic health record (EHR) and administrative claims data to generate real-world evidence.</p>
<p>
The successful candidate will contribute to characterization, population-level estimation (causal inference), and patient-level prediction analyses across multi-institutional data networks. This position offers a unique opportunity to work at the intersection of biomedical informatics, data science, and clinical research within a leading academic medical center.</p>
<p>
This position is a full-time, two-year position with a possibility of an extension, contingent on available funding.</p>
<p></p>
<p>Responsibilities</p>
<p><b>
Key Responsibilities</b></p>
<ul>
<li>Design and implement observational network studies using distributed EHR and administrative claims data</li>
<li>Conduct large-scale characterization, comparative effectiveness and safety estimation, and patient-level prediction analyses</li>
<li>Develop reproducible analytic pipelines using R and SQL in relational database environments</li>
<li>Apply and evaluate methods from causal inference (e.g., confounding control, bias assessment, sensitivity analyses)</li>
<li>Apply machine learning approaches for predictive modeling using high-dimensional healthcare data</li>
<li>Work with standardized data representations, including the OMOP Common Data Model and standardized clinical vocabularies for conditions, drugs, procedures, and measurements</li>
<li>Collaborate with interdisciplinary teams including clinicians, statisticians, data engineers, and informaticians</li>
<li>Contribute to scholarly outputs including manuscripts, presentations, and open-source analytic tools</li>
<li>Support transparent, reproducible, and scalable research practices across distributed data networks</li>
</ul>
<p></p><p>Minimum Qualifications</p>
<p>
Master&rsquo;s degree in biostatistics, public health, epidemiology, informatics, computer science, or related field, and or equivalent in education and experience, with at least 2 years&rsquo; related experience.</p>
<ul>
<li>At least 1 year of relevant prior work experience in the healthcare industry within a health system, a pharmaceutical company, or an insurer</li>
<li>Strong programming experience in R and SQL</li>
<li>Experience working with relational databases and large-scale healthcare datasets</li>
<li>Demonstrated interest in observational research using real-world clinical or claims data</li>
<li>Ability to design, implement, and document reproducible analytic workflows</li>
<li>Strong written and verbal communication skills</li>
</ul>
<p></p><p>Preferred Qualifications</p>
<p>
PhD degree in biostatistics, public health, epidemiology, informatics, computer science, or related field, and/or equivalent and experience in education, with at least 1 year of related work experience.</p>
<p></p>
<p>Other Requirements</p>
<ul>
<li>Familiarity with the OMOP Common Data Model and standardized vocabularies (e.g., ICD, NDC, SNOMED, MedDRA, LOINC, CPT)</li>
<li>Knowledge of causal inference methods for observational studies</li>
<li>Experience with machine learning techniques for patient-level prediction</li>
<li>Prior experience working in distributed or federated data networks</li>
<li>Familiarity with open-source research ecosystems and collaborative scientific communities</li></ul><br>
<p></p>
<p><b>
Work Environment &amp; Opportunities</b></p>
<p>
This position is based at Columbia University&rsquo;s Department of Biomedical Informatics, a world leader in clinical research informatics and observational health data science. The role offers close collaboration with leading researchers, access to large-scale real-world data, and opportunities to contribute to impactful, open, and methodologically rigorous research that informs clinical and policy decision-making. This position is based in New York, NY and has the option to follow a hybrid schedule of 3 days per week working on site and 2 days per week working remotely.</p><br>
<p></p>
<p></p>
<p>Equal Opportunity Employer / Disability / Veteran</p>
<p>
Columbia University is committed to the hiring of qualified local residents.</p></div>

Data Science Engineer

AXIS Capital

<div><div>This is your opportunity to join AXIS Capital &ndash; a trusted global provider of specialty lines insurance and reinsurance. We stand apart for our outstanding client service, intelligent risk taking and superior risk adjusted returns for our shareholders. We also proudly maintain an entrepreneurial, disciplined and ethical corporate culture. As a member of AXIS, you join a team that is among the best in the industry.</div><div></div><div>
At AXIS, we believe that we are only as strong as our people. We strive to create an inclusive and welcoming culture where employees of all backgrounds and from all walks of life feel comfortable and empowered to be themselves. This means that we bring our whole selves to work.</div><div></div><div>
All qualified applicants will receive consideration for employment without regard to race, color, religion or creed, sex, pregnancy, sexual orientation, gender identity or expression, national origin or ancestry, citizenship, physical or mental disability, age, marital status, civil union status, family or parental status, or any other characteristic protected by law. Accommodation is available upon request for candidates taking part in the selection process.</div><div></div><div><b>
Sr Underwriter, Crime and Fidelity - New York or Chicago</b></div><div></div><div>
AXIS&rsquo; North America Wholesale and Retail division seeks a dynamic Sr Underwriter to join our Crime and Fidelity Practice. The Underwriter will act within established guidelines and market to analyze, review, evaluate, and monitor new and renewal accounts for our Commercial Crime practice.</div><div></div><div>
The Underwriter exercises independent judgment in processing accounts and manages underwriting activities typically. Typical holds an Underwriting Authority and manages/develops a book of $5+Million in GWP.</div><div></div><div><b>
Candidate Profile</b></div><div></div><div>
The Sr Underwriter will be a &ldquo;hands-on&rdquo; technical expert with a history of success within a top-tier Commercial Insurance Carrier focused on building a book of commercial crime risk, targeting public &amp; private Middle Market to Complex risk across a wide range of industry verticals including Finical Instructions.</div><div></div><div>
Candidates will have deep contacts across Retail and Wholesale broker channels and full life cycle exposure to portfolio management, solicitation of submissions, underwriting analysis, preparing, issuing indications/quotations/binders, and marketing.</div><div></div><div>
Additionally, the candidate must have an executive presence, demonstrating success in communicating, influencing, and building solid relationships that add value to the AXIS book of business and contribute to longer-term strategic initiatives.</div><div></div><div><b>
Work Profile</b></div><div></div><div>
Based in either our New York office (1166 Avenue of the Americas) or Chicago office (233 South Wacker Drive Sears/Wills Tower). This is a hybrid role; three days a week in the office. Additionally, regular travel is necessary to engage in face-to-face meetings with brokers and clients and participate in industry and company events.</div><div></div><div><b>
Key Duties and Responsibilities:</b></div><ul><li>
Retain existing business while strategically prospecting new opportunities.</li><li>
Manage a book of business regarding new lines, renewals, and cross-marketing of product lines within AXIS: Lower Middle Market, Financial Institutions, Management Liability, Cyber and other business units</li><li>
Analyze and underwrite commercial crime business in compliance with the applicable guidelines and within allocated authority while conforming to best practices and focusing on efficiency and profitability.</li><li>
Build and maintain a broker network to support profitable business origination through the US broker market.</li><li>
Track industry and market developments and raise these for strategic discussions with our internal business partners &ndash; actuary, claims, product development, and field underwriters.</li><li>
Maintain an understanding of all current issues affecting the commercial crime product.</li><li>
Moderate travel to client underwriting meetings, broker visits, and attendance at fidelity industry conferences.</li><li>
Act as a resource for commercial crime products for the field underwriters.</li><li>
Perform the required number of broker marketing calls, including out-of-state travel.</li><li>
Meet all divisional servicing objectives, including but not limited to quote turnaround, policy issuance, phone management, file maintenance, and documentation.</li></ul><div></div><div><b>
Required Education/Training &amp; Experience:</b></div><ul><li>
Bachelor&rsquo;s Degree is required.</li><li>
A minimum of 5 years of commercial crime &amp; fidelity underwriting experience</li><li>
Candidates should have solid industry relationships and be respected by brokers and insurers nationally.</li><li>
A basic knowledge of actuarial and pricing concepts.</li><li>
A firm grasp of policy wording.</li><li>
Understand the role and impact of claims, actuarial, and accounting in underwriting.</li><li>
Excellent interpersonal skills are required to develop and maintain relationships with brokers and internal business partners.</li></ul><div></div><div><b>
Required Skills:</b></div><ul><li>
Strong focus on identifying client needs and flexibility in developing solutions.</li><li>
Enthusiasm for new business opportunities and the desire to think creatively in formulating solutions for clients and brokers.</li><li>
Strong communication and negotiation skills.</li><li>
Acts strategically and exhibits an entrepreneurial mindset.</li><li>
Excellent organizational skills and ability to manage peak period workflows. Excellent negotiation skills and strong marketing abilities.</li><li>
Effective strategic relationship management and portfolio management skills.</li><li>
Highly collaborative and versatile, with the ability to work effectively independently and as part of a team.</li></ul><div></div><div>
We expect to offer a base salary of $160,000 - $190,000 for this position. The specific salary offer will be based on an assessment of various factors, including the successful candidate's experience and work location. In addition, all employees are eligible for competitive incentive targets, with awards based on overall corporate and individual performance. On top of this, we offer a comprehensive and competitive benefits package that includes medical plans for employees and their families, health and wellness programs, retirement plans, tuition reimbursement, paid vacation, and much more. <i>Where this role is based in the United States of America, this role </i><i>is [Exempt/Non-Exempt] for</i><i> FLSA purposes</i></div></div><div></div>

Sr Underwriter, Crime and Fidelity

MANTECH

<div><p><b>MANTECH</b> seeks a motivated, career and customer-oriented <b>Cyber Security Analyst</b> to support our operations in <b>Virginia Beach, VA</b>. This is an <b>onsite</b> position.</p><p></p><p>
In this role, you will be involved in securing critical defense systems by applying rigorous Risk Management Framework (RMF) standards. You will work closely with stakeholders to ensure that cybersecurity architecture and controls meet the highest levels of integrity and compliance.</p><p></p><p><b>
Responsibilities include but are not limited to:</b></p><ul><li><p>
Prepare for RMF execution by defining authorization boundaries, performing system categorization, and applying NIST SP 800-53 security control overlays.
</p></li><li><p>Lead the selection and tailoring of security controls, documenting all risk-based justifications and decisions within the Enterprise Mission Assurance Support Service (eMASS).
</p></li><li><p>Develop and maintain essential cybersecurity documentation, including the System Security Plan (SSP), Contingency Plans, and Incident Response Plans.
</p></li><li><p>Implement and test security controls using DISA STIGs, SRGs, and ACAS/Nessus vulnerability scans to ensure full-scope compliance across all assets.
</p></li><li><p>Assess the effectiveness of security implementations by conducting independent testing and documenting findings to resolve non-compliant controls through the POA&amp;M process.
</p></li><li><p>Support the system authorization process by managing RMF accreditation packages and coordinating formal workflow actions for Authorizing Official (AO) decisions.
</p></li><li><p>Execute continuous monitoring strategies, including monthly vulnerability scans and annual security reviews, to maintain an acceptable system risk posture.</p></li></ul><p></p><p><b>
Minimum Qualifications:</b></p><ul><li><p>
Bachelor&rsquo;s degree in Computer Science, Cybersecurity, Information Systems, or a related field with 2+ years of relevant work experience</p></li><li><p>
DoD 8570 IAT Level II Certification, e.g., Security+</p></li><li><p>
Proficiency in utilizing eMASS to manage security control documentation and POA&amp;Ms</p></li><li><p>
Experience conducting vulnerability assessments using ACAS tool suite</p></li><li><p>
2+ years of direct RMF experience</p></li></ul><p></p><p><b>
Preferred Qualifications:</b></p><ul><li><p>
DOD 8140 Cyber Workforce certification</p></li></ul><p></p><p><b>
Security Clearance:</b></p><ul><li><p>
Must have a current/active DOD Secret Security Clearance</p></li></ul><p></p><p><b>
Physical Requirements</b>:</p><ul><li><p>
The person in this position must be able to remain in a stationary position 50% of the time. Occasionally move about inside the office to access file cabinets, office machinery, or to communicate with co-workers, management, and customers, via email, phone, and or virtual communication, which may involve delivering presentations.</p></li></ul></div>

Cyber Security Analyst

MetroPlusHealth

<div><p><b>Job Ref: </b>133786<br>
<b>Category: </b>Claims<br>
<b>Department: </b>CLAIMS<br>
<b>Location: </b>50 Water Street, 7th Floor, New York, NY 10004
<br>
<b>Job Type: </b>Regular<br>
<b>Employment Type: </b>Full-Time<br>
<b>Salary Range: </b>$48,791.00 - $50,593.00<br>
</p><p></p><div><h2 class="jobSectionHeader"><b>Empower. Unite. Care.</b></h2><p><b>
MetroPlusHealth</b> is committed to empowering New Yorkers by uniting communities through care. We believe that Health care is a right, not a privilege. If you have compassion and a collaborative spirit, work with us. You can come to work being proud of what you do every day.</p><div><div><div><h2 class="jobSectionHeader"><b>
About NYC Health + Hospitals</b></h2><div><div><p>
MetroPlus<b>Health</b> provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc. As a wholly-owned subsidiary of NYC Health + Hospitals, the largest public health system in the United States, MetroPlus<b>Health</b>'s network includes over 27,000 primary care providers, specialists and participating clinics. For more than 40 years, MetroPlus<b>Health</b> has been committed to building strong relationships with its members and providers.</p><p><b>
Position Overview</b></p><p>
As a Claims Adjustment Specialist I, this individual will be responsible for analyzing standard to complex post-paid healthcare claims that require in depth research to determine accuracy and mitigate payment errors. The Claims Adjustment Specialist I will also be responsible for adjusting medical claims that result in overpayment or underpayment due to claim processing system issues, contract amendments, processing errors, or other issues. This position will be responsible for responding to inquiries from providers whose claims may be paid incorrectly and performing accurate data entry and maintenance accurate records and files.</p></div></div></div></div><div><div><h2 class="jobSectionHeader"><b>
Work Shifts</b></h2><div><div><p><b>
7:00 A.M &ndash; 3:30 P.M</b><br>
<b>8:00 A.M &ndash; 4:00 P.M</b><br>
<b>8:30 A.M &ndash; 4:30 P.M</b><br>
<b>9:00 A.M &ndash; 5:00 P.M</b><br>
<b>10:00 A.M &ndash; 6:00 P.M</b></p></div></div></div></div><div><div><h2 class="jobSectionHeader"><b><br>
Duties &amp; Responsibilities</b></h2><div><div><ul><li>
Research and analyze medical claims adjustment requests along with related documentation to determine payment accuracy and adjust/adjudicate as needed using multiple systems and platforms.</li><li>
Ensure that the proper payment guidelines are applied to each claim by using the appropriate tools, processes, and procedures (e.g., claims processing P&amp;P&rsquo;s, grievance procedures, state mandates, CMS/Medicare/Medicaid guidelines, benefit plans, etc.)</li><li>
Research claims that may have paid incorrectly and communicate findings for adjustment; Adjust claims based on findings (i.e., correct coding, rates of reimbursement, authorizations, contracted amounts etc.) ensuring that all relevant information is considered.</li><li>
Advise business partners of findings outcome if their input is needed to help fix the issue.</li><li>
Communicate through correspondence with providers regarding claim payment or additional required information in a clear and concise manner.</li><li>
Process the adjustment of claims in a timely manner, according to established timelines.</li><li>
Remain current with changes/updates in claims processing, as well as updates to coding systems.</li><li>
Maintain accurate records of all claims processed, including notes on actions taken.</li><li>
Generate reports on claim activity as requested.</li><li>
Respond to audits of claims processed.</li><li>
Able to work independently and exercise good judgment<br>
</li></ul></div></div></div></div><div><div><h2 class="jobSectionHeader"><b>
Minimum Qualifications</b></h2><div><div><ul><li>
High School Degree or evidence of having passed a High School Equivalency Program required. Associate degree preferred.</li><li>
Minimum 2 years of claims operations experience in a healthcare field, with knowledge of integrated claims processing required.</li><li>
Experience using a PC and claim adjudication system(s)</li><li>
Experience using Customer Relationship Management (CRM) software; Salesforce is a plus.</li><li>
Experience working with large data and spreadsheets.</li><li>
Knowledge of medical terminology, CPT, ICD-10, and Revenue Codes</li><li>
Processing of Medical Claim Forms (HCFA, UB04)</li><li>
Knowledge of Medical Terminology</li><li>
Knowledge of HIPPA Guidelines regarding Protected Health Information</li><li>
Data Entry of Provider Claim/Billing information</li><li>
Experience handling or familiarity with Medical Claim inquiries from provider sites personnel including physicians, clinical staff, and site administrators.</li></ul><p><b>
Professional Competencies</b></p><ul><li>
Integrity and Trust</li><li>
Customer Focus</li><li>
Functional/Technical skills</li><li>
Written/Oral Communication</li><li>
Strong Analytical Skills</li><li>
Knowledgeable in MS Word and Excel</li></ul><p>
#LI-Hybrid</p><p>
#MHP50</p></div></div></div></div><div><div><h2 class="jobSectionHeader"><b>
Benefits</b></h2><div><div><p>
NYC Health and Hospitals offers a competitive benefits package that includes:</p><ul><li>
Comprehensive Health Benefits for employees hired to work 20+ hrs. per week</li><li>
Retirement Savings and Pension Plans</li><li>
Paid Holidays and Vacation in accordance with employees' Collectively bargained contracts</li><li>
Loan Forgiveness Programs for eligible employees</li><li>
College tuition discounts and professional development opportunities</li><li>
College Savings Program</li><li>
Union Benefits for eligible titles</li><li>
Multiple employee discounts programs</li><li>
Commuter Benefits Programs</li></ul></div></div></div></div></div></div></div><p></p>

Claims Adjustment Specialist I

Google

<div>
 Note: By applying to this position you will have an opportunity to share your preferred working location from the following:
 <strong>
  New York, NY, USA; Cambridge, MA, USA
 </strong>
 .
 <strong>
  Minimum qualifications:
  <br/>
  <br/>
 </strong>
 <ul>
  <li>
   Bachelor's degree in Computer Science, Information Systems, Cybersecurity, a related technical field, or equivalent practical experience.
  </li>
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   3 years of experience working with end-to-end incident response investigations, analysis, or containment actions.
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   3 years of investigative experience with network forensics, malware triage analysis, cloud forensics, or disk and memory forensics.
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   Ability to travel up to 30% of the time.
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  Preferred qualifications:
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   Certifications in Cloud platforms.
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   Experience in security competitions, Capture the Flags (CTFs) or testing platforms such as Hack the Box, TryHackMe, Overthewire, etc.
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   Ability to communicate investigative findings and strategies to technical staff, executive leadership, legal counsel, and internal and external clients.
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   Excellent time and project management skills.
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  About The Job
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 As a Security Consultant, you will be responsible for helping clients effectively prepare for, proactively mitigate, and detect and respond to cyber security threats. Security Consultants have an understanding of computer science, operating system functionality and networking, cloud services, corporate network environments and how to apply this knowledge to cyber security threats.
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 As a Security Consultant, you could work on engagements including assisting clients in navigating technically complex and high-profile incidents, performing forensic analysis, threat hunting, and malware triage. You may also test client networks, applications and devices by emulating the latest techniques to help them defend against threats, and will be the technical advocate for information security requirements and provide an in-depth understanding of the information security domain. You will also articulate and present complex concepts to business stakeholders, executive leadership, and technical contributors and successfully lead complex engagements alongside cross functional teams.
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 As an Incident Response Consultant, you will provide industry-leading incident response, assessment, transformation, managed detection and response, and training services with in-depth tactical support. You will help organizations effectively detect and respond to threats and reduce the overall impact of business risk before, during, and after an incident. You will be able to resolve security incidents quickly, effectively and at scale with complete incident response including investigation, containment, remediation, and crisis management. In this role, you will work on engagements including assisting clients in navigating technically complex and high-profile incidents, performing forensic analysis, threat hunting, and malware triage.
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 Part of Google Cloud, Mandiant is a recognized leader in dynamic cyber defense, threat intelligence and incident response services. Mandiant's cybersecurity expertise has earned the trust of security professionals and company executives around the world. Our unique combination of renowned frontline experience responding to some of the most complex breaches, nation-state grade threat intelligence, machine intelligence, and the industry's best security validation ensures that Mandiant knows more about today's advanced threats than anyone.
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 The US base salary range for this full-time position is $113,000-$161,000 + bonus + equity + benefits. Our salary ranges are determined by role, level, and location. Within the range, individual pay is determined by work location and additional factors, including job-related skills, experience, and relevant education or training. Your recruiter can share more about the specific salary range for your preferred location during the hiring process.
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 Please note that the compensation details listed in US role postings reflect the base salary only, and do not include bonus, equity, or benefits. Learn more about benefits at Google .
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  Responsibilities
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   Collaborate with internal and customer teams to investigate and contain incidents. Conduct host forensics, network forensics, log analysis, and malware triage in support of incident response investigations.
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   Recognize and codify attacker Tools, Tactics, and Procedures (TTPs) and Indicators of Compromise (IOCs). Build scripts, tools, or methodologies to enhance Mandiant&rsquo;s incident investigation processes that can be applied to current and future investigations.
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   Develop and present comprehensive and accurate reports, trainings, and presentations for technical and executive audiences.
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   Utilize Mandiant technology to conduct large-scale investigations and examine end-point and network-based sources of evidence.
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 Google is proud to be an equal opportunity workplace and is an affirmative action employer. We are committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender identity or Veteran status. We also consider qualified applicants regardless of criminal histories, consistent with legal requirements. See also Google's EEO Policy and EEO is the Law. If you have a disability or special need that requires accommodation, please let us know by completing our Accommodations for Applicants form .
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Security Consultant, Digital Forensics Incident Response, Mandiant

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