- University of Rochester (Rochester, NY)
- …which have not been collected through routine billing and collection activities. Claim Resolution Rep III will make independent decisions as to the processes ... necessary to collect denied insurance claims , no response accounts, and will investigate resolving billing...to the attention of billing Manager and Supervisor. The Claim Resolution Rep III will represent the department and… more
- University of Rochester (Rochester, NY)
- …to insurance companies to determine reason for claim denial or reason for unpaid claim . Address unpaid claims , and solicit a payment date from the payer. + ... Research and calculate underpaid or overpaid claims ; determine final resolution.- - - Re-calculate claim based on fee schedule, APC or APG grouper, appropriate %… more
- Molina Healthcare (Syracuse, NY)
- …Lead Analyst, Configuration Oversight to support our Payment Integrity and Claims Operations teams in ensuring the accuracy and compliance of Coordination ... of Benefits (COB) claim pricing and processing. This role will focus on...guidance. The ideal candidate will bring deep knowledge of claims adjudication, QNXT system navigation, and strong analytical acumen.… more
- University of Rochester (Rochester, NY)
- …**Responsibilities:** GENERAL PURPOSE With considerable latitude for independent judgment, the Claim Resolution Rep IV is responsible for the follow up and ... point person for complex accounts. Serves as main point of contact in claim resolution process for Strong Memorial Hospital (SMH) clinical staff and outside agencies… more
- University of Rochester (Albany, NY)
- …pertain to claim processing and coding. Escalates system issues preventing claims submission and follow-up for review and resolution. + 5% Collaborates with ... individual, and internal equity considerations._ **Responsibilities:** GENERAL PURPOSE The Claims Resolution Representative III is responsible for working across the… more
- The Institute for Family Health (New Paltz, NY)
- …and facilitates resolution. + May be responsible for Claim Printing/Reviewing of printed claim forms for accuracy to ensure claims are paid timely. + May be ... that processing of denials are at optimal levels + Ensure daily/weekly/monthly medical claim submission. Resolve claim and remittance file issues as needed. +… more
- New York State Civil Service (Albany, NY)
- …Manager, Cost Control takes a lead role in Project Controls functions of claims management, claims negotiation, and litigation support on complex capital ... environmental issues and other non-traditional project variables. Essential FunctionsDevelop claims strategies as needed on projects. Oversee analysis of … more
- GE Vernova (Schenectady, NY)
- …supporting the North America (NAM) region. In this role, you will manage warranty claims with a focus on reducing cycle time, ensuring accurate cost allocation, and ... **Job Description** **Roles and Responsibilities** + Manage and track warranty claims from initiation through resolution, ensuring timely processing and closure. +… more
- Sedgwick (Albany, NY)
- …an expected caseload efficiently. + Utilizes technology and automation tools for efficient claim handling. + Sends claims exceeding $15,000 gross loss amount to ... **_Bilingual/French Speaking Desk Adjuster_** **PRIMARY PURPOSE** **:** Handles losses and claims valued up to $15,000 for property and casualty insurers through… more
- University of Rochester (Rochester, NY)
- … to obtain and verify insurance coverage. + Follows up on unpaid accounts working claims . + Reviews reasons for claim denial. + Reviews payer website or contacts ... open account receivables to successful closure. Responsible for an effective claims follow-up to obtain maximum revenue collection. Researches, corrects, resubmits … more