- Northwell Health (Melville, NY)
- …and medical necessity for assigned case. Collaborates with physician advisor, payor representative and site case managers to facilitate appropriate level of care ... current state, federal, and third-party payer regulations. Ensures clinical reviews and appeals are up to date and accurately reflect patient's severity of illness… more
- HANAC, Inc. (Astoria, NY)
- …integral part of a team with the immigration attorney, Board of Immigration Appeals (BIA) accredited representative , and support staff. The Immigration Paralegal ... will assist the staff attorney and the Program Director in providing legal services, education, and outreach, including coordination of community events, and working under attorney supervision to assist clients on Immigration law matters. The Paralegal will… more
- Independent Health (Buffalo, NY)
- …and 5pm** **Monday through Friday** . **Overview** The Provider Relations Representative will be responsible for assisting our provider constituents and providing ... exceptional customer service. The Provider Relations Representative will answer incoming calls from health care providers including physician offices, ancillary… more
- CDPHP (Albany, NY)
- …invites you to be a part of that experience. The Customer Care Representative shall assume full responsibility and ownership for all aspects regarding education of ... advise the customer of their rights and responsibilities. The Member Service Representative will work closely with all departments, such as Marketing, Enrollment,… more
- New York State Civil Service (Albany, NY)
- …rules, regulations and case law. The incumbent serves as the Chancellor's representative in hearing appeals of disciplinary and contract grievances pursuant ... policy for classified service employees.- Serves as the University's representative in the administration of the grievance procedures (contract, non-contract… more
- Brighton Health Plan Solutions, LLC (New York, NY)
- About The Role The Customer Service Representative assists members, physicians, hospitals, revenue agencies and other healthcare providers with member benefits, ... eligibility, claims inquiry, claim reconsiderations and appeals . The Customer Service Representatives must be able to work in various shifts Monday to Friday between… more
- MTA (New York, NY)
- Senior Labor Relations Representative Job ID: 12716 Business Unit: MTA Headquarters Location: New York, NY, United States Regular/Temporary: Regular Department: ... Date Posted: Aug 15, 2025 Description JOB TITLE: Senior Labor Relations Representative DEPT/DIV: Labor Relations WORK LOCATION: 420 Lexington Ave FULL/PART-TIME FUL… more
- Rochester Regional Health (Rochester, NY)
- Job Title: Business Office Representative Department: Location: Hours Per Week: Schedule: Sign-On Bonus: SUMMARY: Ensure full reimbursement is received by RRH for ... coverage policies and/or phone calls to the payer. Submit corrected claims and appeals . + Process account adjustments and refunds as needed according to department… more
- Cardinal Health (Albany, NY)
- …the appropriate system. + Manages and resolves complex insurance claims, including appeals and denials, to ensure timely and accurate reimbursement. + Processes ... denials & rejections for re-submission (billing) in accordance with company policy, regulations, or third-party policy. + More challenging claim cases + Investigates and updates the system with all information received from secondary insurance companies. +… more
- Northwell Health (Lake Success, NY)
- …Carries out clinical documentation requests to business office to ensure timely appeals . + Implements policies and procedures to facilitate billing and maximize case ... collections. + Implements improvements for financial management of each billing area. + Performs related duties as required. All responsibilities noted here are considered essential functions of the job under the Americans with Disabilities Act. Duties not… more