- MTA (New York, NY)
- …for the overall management of a staff of 2 people including the Sr Claims Administrator, 1 Analyst and approximately 7 consultants. + Responsible for the management ... and assess loss picks, ensuring accuracy in estimating future claims costs. Oversees OCIP claims and settlements...cost, accuracy and best practices. + Monitors and manages claim reserves, working with TPAs and insurers to adjust… more
- Sedgwick (Albany, NY)
- …evaluates, negotiates, and resolves recreational marine or personal watercraft claims internationally, regardless of complexity and quantum. **ESSENTIAL FUNCTIONS ... and RESPONSIBILITIES** + Investigates recreational marine or personal watercraft claims thoroughly using technical expertise and complex analysis. + Examines… more
- CVS Health (Amherst, NY)
- …monthly invoices in accounting system. + Enter and process monthly fee claims for ancillary product offerings via claim system. **Required Qualifications** ... + 2+ years of experience working in an accounting system, including accounts receivable, accounts payable, auditing, and billing. **Preferred Qualifications** + Resides in Amherst, New York, with the ability to work a hybrid schedule in the local office. +… more
- Mount Sinai Health System (New York, NY)
- …in relevant RCM modules (eg, Resolute Professional Billing, Hospital Billing, Claims , Contract Management) strongly preferred. + Minimum 7-10 years of progressive ... ensure optimized processes deliver measurable improvements in cost-to-collect, clean claim rates, denial reduction, and cash acceleration. 4. Workflow… more
- Highmark Health (Albany, NY)
- …dental offices. Formally present and effectively communicate UCD's administrative and claim guidelines and policies, benefits of participation, fee schedules, plan ... ensure they utilize various means of automated communication, as well as, claims and electronic data interchange and electronic funds transfer. Collaborate with… more
- Molina Healthcare (Rochester, NY)
- …Evaluate root cause for the disputes and recommend improvements to reduce claim errors and prevent improper payments. + Provide actionable insights and ... care or payer environment. + In-depth knowledge of medical and hospital claims processing, including CPT/HCPCS, ICD, and modifier usage. + Strong understanding of… more
- New York State Civil Service (Albany, NY)
- …SAMS software program to perform the annual review of school district State Aid claim submissions to ensure reasonability of data for use in aid calculations and ... implementation of guidelines and procedures, and risk-based analysis for post-edit claim verification projects;* Process revisions to school districts' prior year… more
- FlexStaff (Chappaqua, NY)
- …minimum of 2 years of experience in medical billing, including filing claim appeals. The ideal candidate will have strong organizational skills, excellent attention ... based on fee schedules - Prepare and submit appeals for underpaid or denied claims - Follow up with insurance carriers regarding outstanding balances - Respond to… more
- Philadelphia Insurance Companies (New York, NY)
- …staff of account executives, underwriters and loss prevention engineers and fair and timely claim settlement from a skilled team of claim professionals. We work ... + Work closely with other internal departments such as operations, loss control, claims , marketing, audit and accounting to meet client service goals and increase… more
- Molina Healthcare (Buffalo, NY)
- JOB DESCRIPTION Provides support for claims activities including reviewing and resolving **Provider No Surprises Act** cases in accordance with the standards and ... ensure that internal and/or regulatory timelines are measured correctly. * Researches claims using support systems to determine **Provider No Surprise Act** cases… more