- University of Rochester (Rochester, NY)
- …Re-submits claims that fail third party edits and submits second level claims . Provides guidance and support to Billing Assistant and answers correspondence. ... received. + Documents all actions thoroughly in visit notes. 30% Corrects claim errors returned post-submission. + Reviews claims requiring non-routine… 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 ...of credits - - Review and advise supervisor or manager on trends of incorrectly paid claims … more
- University of Rochester (Rochester, NY)
- …conforms to federal and state regulations bringing concerns to the attention of billing Manager and Supervisor. The Claim Resolution Rep III will represent the ... not been collected through routine billing and collection activities. Claim Resolution Rep III will make independent decisions as...insurance refund credits. + Review and advise supervisor or manager of trends on incorrectly paid claims … more
- Tutor Perini (White Plains, NY)
- …and Claims Register. + Participate in negotiation of change orders or claims with clients, subcontractors, or vendors. + Support dispute resolution through ... future Frontier-Kemper, a Tutor Perini Company, is seeking a **Change Control Manager ** to join our Kensico-Eastview Connection Tunnel Project in White Plains, New… more
- GE Vernova (Schenectady, NY)
- **Job Description Summary** Job Description Summary The Contract Manager supports the project team on all contractual issues (ranging from equipment (EO/EEP) and ... project execution and ensures that commercial risks and opportunities (notably claims , change orders, vendor and insurance recoveries) are identified early, tracked,… more
- Molina Healthcare (Syracuse, NY)
- …Summary** We are seeking a highly experienced 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)
- …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 ...refund of credits + Review and advise supervisor or manager on trends of incorrectly paid claims … more
- Highmark Health (Albany, NY)
- …forecasts, forwarding concerns and recommendations to the Workforce Planning Team Manager . 3. Support scheduling impacts of longer-term initiatives, events, ... **GENERAL OVERVIEW:** Primary accountability is to perform Command Center support to call center teams and provide evaluation and...or trends. Work with Workforce Planning Team Manager and Customer Service Management team to appropriately schedule… 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
- Latham, The Pool Company (Latham, NY)
- … communicates with homeowners and dealers regarding warranty/ non warranty items ( claims , repairs, inquiries, etc.). This manager will handle escalations from ... warranty admin staff, sales, and other internal stakeholders. The manager will be responsible for daily reporting, employee development, and other projects as… more