- Oak Orchard Health (Brockport, NY)
- …the third-party billing organization to ensure proper processing of all payer claims . This would include research for accuracy, analyze reports, follow through ... the third-party billing company + Manage Accounts Receivable related to all claims and ensure reconciliation with the general ledger. This involves working closely… more
- MVP Health Care (Rochester, NY)
- …justice or a related field, and minimum of five years of insurance claims investigation experience; or five years of professional investigation experience with law ... CPT-4, ICD-9-CM, ICD-10-CM, HCPCS and CPT Assistant coding guidelines as they relate to claim data. + Working knowledge of MS Office (Word, Excel and Outlook) +… more
- CVS Health (Albany, NY)
- …measuring and monitoring the quality and effectiveness of work processes in claim processing and customer service that impact customer satisfaction, medical cost ... of problem solving and decision making skills + College degree preferred + Claims experience + DG experience **Education** + High School Diploma or equivalent GED… more
- Hannaford (Highland, NY)
- …forms after prescriptions are dispensed. * Prepare and complete manual insurance claim forms. * Maintain organized filing system for invoices, manual insurance ... claims , daily reports, etc. in accordance with Standard Practice Manual and state law. * Help customers find over the counter items. * Maintain a broad understanding… more
- Westchester Jewish Community Services (White Plains, NY)
- …3rd Party Insurance. This position ensures timely and accurate processing of claims , collections, and account reconciliations to support the financial health of our ... billing for Managed Care, Medicaid, and Third-Party Payers, ensuring timely claim submission, editing, transmission, and verification. + Manage collections and… more
- City of New York (New York, NY)
- …Clerical Associates, Eligibility Specialist, and Principal Administrative Associates involved in claim review and processing. - Assign, evaluate and review completed ... - Liaise with the Social Security Administration on any issues related to the claims or the use of the Government Service Online (GSO) application. Salary Range:… more
- Cognizant (Albany, NY)
- …processes, training, continuous improvement, system automation. + System health monitoring of: Claim adjudication jobs, ASP alerts, CPU alerts, Claims queue ... monitoring, Storage monitoring, Connect Direct subsystem. + Contact different teams if requested by on-call + For application upgrade events, place job queues on HOLD for MOD and Patch instances + Responsible for performing and monitoring all backups on the… more
- Humana (Albany, NY)
- …PowerPoint, and Lucid. **Preferred Qualifications** + Minimum 1 year of experience medical claims payment and processing in a medical claim 's environment + ... Experience creating pivot tables and consumable information within Excel + Knowledgeable in regulations governing health care industries or related adjacent industries **Additional Information** **Work-At-Home Requirements:** + WAH requirements: Must have the… more
- Arnot Health (Elmira, NY)
- …coding/billing regulations (LCDs, NCDs, NYS insurance laws, payer policies) + Assist in claim edit resolution to ensure compliant, clean claims are submitted + ... Maintain proficiency in CPT, HCPCS, ICD-10, OPPS, and related coding structures + Collaborate with Finance and IT to troubleshoot revenue-related system issues + Update internal procedural documentation based on regulation or policy changes + Develop and… more
- CVS Health (Albany, NY)
- …Summary** The Negotiator Analyst is responsible for negotiating out-of-network (OON) medical claims valued at $10,000 and above. This role involves learning the ... **Required Qualifications** + 3-5 years of experience in a medical claim background with understanding of benchmarking costs for medical services, supplies,… more