- Molina Healthcare (Syracuse, NY)
- …and Marketplace benefits and services including reviewing and resolving member appeals and complaints, then communicating resolution to members or authorized ... **Essential Job Duties** * Facilitates comprehensive research and resolution of appeals , disputes, grievances, and/or complaints from Molina members, providers, and… more
- Molina Healthcare (Rochester, NY)
- …Services (CMS). **Essential Job Duties** * Enters denials and requests for appeals into information system and prepares documentation for further review. * ... systems and other available resources. * Assures timeliness and appropriateness of appeals according to state, federal and Molina guidelines. * Requests and obtains… more
- Molina Healthcare (Syracuse, NY)
- …+ Responsible for the comprehensive research and resolution of the appeals , dispute, grievances, and/or complaints from Molina members, providers and related ... ensure that internal and/or regulatory timelines are met. + Research claims appeals and grievances using support systems to determine appeal and grievance outcomes.… more
- Molina Healthcare (Buffalo, NY)
- …* At least 2 years of managed care experience in a call center, appeals , and/or claims environment, or equivalent combination of relevant education and experience. * ... and eligibility criteria. * Experience with Medicaid and Medicare claims denials and appeals processing, and knowledge of regulatory guidelines for appeals and… more
- Molina Healthcare (Buffalo, NY)
- **JOB DESCRIPTION** **Job Summary** The Clinical Appeals Nurse (RN) provides support for internal appeals clinical processes - ensuring that appeals requests ... strategy to provide quality and cost-effective member care. Candidates with UM and Appeals experience are highly preferred Work hours: Monday- Friday 8:00am - 5:00pm… more
- FlexStaff (Chappaqua, NY)
- **Req Number** 159695 FlexStaff Our client is seeking a skilled AR Specialist / Biller with a minimum of 2 years of experience in medical billing, including filing ... claim appeals . The ideal candidate will have strong organizational skills,...accuracy based on fee schedules - Prepare and submit appeals for underpaid or denied claims - Follow up… more
- Stony Brook University (East Setauket, NY)
- Revenue Specialist **Position Summary** At Stony Brook Medicine, a **Revenue Specialist ** will provide operational support within the hospital's Patient ... business functions including but not limited to: billing, claims analysis appeals , follow-up, financial assistance and customer service. **Duties of a Revenue… more
- Helio Health Inc. (Syracuse, NY)
- Overview To support the mission of Helio Health, Inc., the Billing Specialist generates medical invoices, posts cash receipts, follows up on accounts receivable and ... as required to accomplish medical billing for Helio Health. The Billing Specialist will work Full-Timeto support our Revenue Cycle Management team. This position… more
- Mount Sinai Health System (New York, NY)
- **Job Description** The Procedural Billing Specialist I is responsible for multiple components of the complex billing and coding process for specialized procedures, ... to ensure accurate and timely payment of claims and collection. The Specialist works directly with the Department Administrator. Reports to Billing Manager/Revenue… more
- Research Foundation CUNY (New York, NY)
- Job Title: Early Childhood Rating Specialist PVN ID: VA-2411-006584 Category: Managerial and Professional Location: OFFICE OF SR. UNIV DEAN FOR ACADEMIC AFFAIRS Job ... early childhood workforce across New York State. GENERAL DESCRIPTION The Ratings Specialist is responsible for providing key support to the implementation of… more