- University of Rochester (Albany, NY)
- …individual, and internal equity considerations._ **Responsibilities:** GENERAL PURPOSE The Claims Resolution Representative III is responsible for working across the ... all open accounts receivable to successful closure. Responsible for effective claims follow-up on complex, multi-faceted accounts to obtain maximum revenue… more
- Allied Universal (Rochester, NY)
- ** Company Overview:** Advance Your Career in Insurance Claims with Allied Universal(R) Compliance and Investigation Services. Allied Universal(R) Compliance and ... Investigation Services is the premier destination for a career in insurance claim investigation. As a global leader, we provide dynamic opportunities for claim … more
- Sedgwick (Albany, NY)
- …of claims including comprehension of medical terminology and substantiating claim decisions. **ADDITIONAL FUNCTIONS and RESPONSIBILITIES** + Acts as a backup for ... Clinical Specialist **PRIMARY PURPOSE** : Performs standard clinical evaluations on claims that require additional review based on medical condition, client… more
- University of Rochester (Rochester, NY)
- …individual, and internal equity considerations._ **Responsibilities:** GENERAL PURPOSE The claims resolution representative II is responsible for working across the ... all open account receivables to successful closure. Responsible for effective claims follow-up to obtain maximum revenue collection. Responsibilities include but are… more
- GE Aerospace (Schenectady, NY)
- …In this high-impact role, you'll deliver sharp insights, adjudicate complex claims , and collaborate across teams using advanced analytics and emerging technology. ... and plan + Perform desk and/or field audits of reinsured claims , policies or administrative processes, documenting findings and recommendations using established… more
- Travelers Insurance Company (Albany, NY)
- …Imagine loving what you do and where you do it. **Job Category** Claim **Compensation Overview** The annual base salary range provided for this position is ... **What Is the Opportunity?** Lead the strategy and operations of Travelers Claim Medical initiatives focusing on how developments in the broader medical environment… more
- Highmark Health (Albany, NY)
- ** Company :** Highmark Inc. **Job Description :** **JOB SUMMARY** This job requires the ability to identify issues related to professional and facility provider ... claims data including determining appropriateness of code submission, analysis of the claim rejection and the proper action to complete the retrospective claim… more
- Highmark Health (Albany, NY)
- …inquiries concerning oral, injectable and infusion medication requests, and drug claim edits/prior authorizations. By reviewing member claims history, clearly ... ** Company :** Highmark Inc. **Job Description :** **JOB...and/or assist in addressing denied point of sale prescription claim transitions and coordination of benefits practices/procedures. **ESSENTIAL RESPONSIBILITIES**… more
- Robert Half Legal (New York, NY)
- Description We are seeking a Claims Technical Specialist to oversee the examination, evaluation, and processing of complex claims estimates and paid claims ... policy terms and conditions in alignment with the client's Claims Philosophy. This role supports the claims ...settlement, and fair resolution of disputes in line with company guidelines. The selected candidate will manage the complete… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …policies and procedures and related health plan functions such as member services, claims , and the referral process. As well as functions related to legislative and ... case for clinical staff. + Navigates and utilizes corporate applications; core claims and membership system, intranet and related links to provide support to… more