- Molina Healthcare (Rochester, NY)
- …activities surrounding material updates including provider manuals, letters, and other correspondence related to Medicare Contracted Provider Appeals and ... the activities of the Medicare Contracted Provider Post-Pay Claim Appeals and Disputes in accordance with the standards and... and grievance processing/resolution, including 2 years in a manager role. * Experience reviewing all types of medical… more
- Mount Sinai Health System (New York, NY)
- …as per department protocol (IPRO Discharge Appeals / Insurance requests) + Support Appeals Nurse / Manager by confirming status of denials + Tracking status ... of the Case Management Department by monitoring all incoming correspondence and ensuring it reaches the responsible individuals. Must...+ Requests or provides Medical Records as required for appeals , On / Off-site Insurance reviews + Implements… more
- Arnot Health (Elmira, NY)
- …3rd party payers 3. Reviews denials from third party payers obtained from correspondence and or payments. Assists in tracking/trending by payer for denial reason ... errors, types and recurring issues. 4. Facilitates, coordinates and prepares denial appeals working with internal and external customers in a proactive manner to… more
- University of Rochester (Rochester, NY)
- …provider preferences and protocols in selecting for routine and non-routine letters of correspondence related to appeals on denied claims, billing and patient ... GENERAL PURPOSE Under the direct supervision of the Practice Manager , Clinic Director and Nurse Manager works...the Practice Manager , Clinic Director and Nurse Manager works with considerable latitude for independent judgement. Responsible… more
- The Institute for Family Health (New Paltz, NY)
- …existing policies and procedures for the assigned area. + Reviews and processes correspondence on a daily basis. + Reviews and processes Explanation of Benefits for ... support to senior representatives such as mailing paper claims, preparing spreadsheets for appeals , or maintaining data spreadsheets as directed by the manager … more
- University of Rochester (Rochester, NY)
- …closure and obtain maximum revenue collection. Researches, corrects, resubmits claims, submits appeals and takes timely and routine action to resolve unpaid claims. ... collection. Key Functions and Expected Performances With general direction of the Manager and with latitude for initiative and judgment: 40% Utilizes A/R experience… more
- Mount Sinai Health System (New York, NY)
- …with appropriate corrections and documentation. 2. Works declines and processes appeals . 3. Ensures that established billing targets for collections, gross, days ... researches and resolves complex claims and corrects errors. 7. Reviews correspondence and rejection data from insurance carriers; posts rejections and performs… more
- New York State Civil Service (Albany, NY)
- …files and database system for NYS Courts (Supreme, Appellate, Court of Appeals .)Properly format documents to upload to various Court e-filing systems. Prepare court ... papers and correspondence for attorney signature. Review record on appeal for any omissions or discrepancies. Gather materials for attorney's reply. Prepare… more
- Health Advocates Network (Albany, NY)
- …communication skills. Perform related duties as required: * Screen requests for External Appeals in accordance with the Federal No Surprise Act. * Screen requests ... attendance are critical. *Telecommuting may be allowable upon discretion of the hiring manager . *Client does not provide parking, but the office is accessible by… more
- University of Rochester (Albany, NY)
- …Receivable Management. **ESSENTIAL FUNCTIONS** With general direction of the Manager /Supervisor/Lead: + 40% Follows department policies and procedures and maintains ... up on multi-faceted denials through review of remittances (EOBs), insurance correspondence , rejections received thru daily electronic and claims submission, etc.… more