- Molina Healthcare (Buffalo, NY)
- …member enrollment, provider information management, benefits configuration and claims processing teams to appropriately address provider claim issues. * ... JOB DESCRIPTION Job Summary Provides support for provider claims adjudication activities including responding to providers to address claim issues, and… more
- Aston Carter (Bronx, NY)
- Claims Processing Specialist Description Under the guidance of a manager, this role involves handling a range of specialized and analytical tasks related to auto ... compensation claims . Responsibilities include monitoring, coordinating, and processing claims , maintaining detailed case documentation, and interviewing… more
- MetLife (Oriskany, NY)
- …to the Beneficiary. May also be responsible for setting up new claims , processing incoming mail, and handling expired call-ups. Principal Responsibilities: ... and receive (standardized) e-mail for communication with agencies/OFEGLI staff and managers. 8. Processing incoming mail for new and existing claims . 9. Write… more
- Axis (New York, NY)
- …to resolve complex or contentious claims . Leading initiatives to enhance claims processing efficiency and accuracy within the team. Providing expert opinions ... is hiring a Claims Specialist, Health Care Claims , for its North America Claim Team....and directing the development of training materials relevant to claims processing . Show a commitment to continuous… more
- New York State Civil Service (New York, NY)
- …Representative 2, the incumbent will oversee all aspects of workers compensation claims processing from inception to closing; initially determine the ... NY HELP Yes Agency Insurance Fund, State Title Claims Services Representative Trainee 1 (NY HELPS) Occupational...with case analysis over the anticipated life of the claim ; recommend cases for appeal to WCB; negotiate and/or… more
- Molina Healthcare (Syracuse, NY)
- …of incorrect coding, abuse and fraudulent billing practices, waste, overpayments, and claims processing errors. **Essential Job Duties** + Audits the ... leadership for improvements based on audit results. + Reviews timeliness of claims processing to ensure compliance with contractual and state/federal… more
- Centers Plan for Healthy Living (Staten Island, NY)
- …equivalent healthcare experience Preferred: Type of Experience Required: 2+ years of claim processing experience with a Medicaid/Medicare Health Plan. Preferred: ... Responsible for the auditing functions of Centers Plan for Healthy Living (CPHL) claims . Collaborates with other Health plan departments and Management to ensure … more
- Albany Medical Center (Albany, NY)
- …Knowledge in billing codes and EDI requirements. Knowledge of electronic claims processing and edits. Excellent decision-making skills, detail oriented, ... + Knowledge in billing codes and EDI requirements. + Knowledge of electronic claims processing and edits. + Excellent decision-making skills, detail oriented,… more
- Albany Medical Center (Albany, NY)
- …preferred.Knowledge in billing codes and EDI requirements.Knowledge of electronic claims processing and edits.Excellent decision-making skills, detail oriented, ... and have the ability to submit factual, timely and compelling appeal letters to payors regarding payment variances and denials.Able to communicate effectively and successfully with team members, providers, contractors, payors, and their Leadership group daily.… more
- City of New York (New York, NY)
- …Staff Analyst NM III to function as a(n) Executive Director, Financial Review & Claims Processing who will: - Manage, plan and develop the operational activities ... of DFRP, ICP and SNAP-CR Directors as they administer their specific program areas which are responsible for initiating adverse actions on cash assistance cases due to information obtained via computer matches, sanctioning individuals who fail to cooperate… more
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