- 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
- City of New York (New York, NY)
- …statutory, regulatory, and contractual standards. The Division of Financial Review and Processing (DFRP) is responsible for the initiation of adverse actions on cash ... of the Bureau of Fraud Investigation, Liens and Recovery, Claims and Collections and the Assistance Reimbursement Unit. Their...seven Eligibility Specialist level IIIs to function as Group Processing Workers, who will: - Confirm accuracy of data… more
- University of Rochester (Albany, NY)
- …requirements and rejection or denial codes as they pertain to claim processing and coding. Escalates system issues preventing claims submission and follow-up ... through telephone calls, payer website, and written communication to ensure accurate processing of claims . Collaborate with appropriate departments to generate a… more
- Uniland Development Company (Amherst, NY)
- …Primary responsibilities of this position include managing Uniland's insurance policies and claims processes, assisting with claim and incident resolution and ... + Maintains insurance claim logs and tracking systems, monitoring claim status, settlement negotiations, and payment processing . + Prepares correspondence… more
- University of Rochester (Rochester, NY)
- …informed of trends. + Remains current on changes in billing requirements associated with claim processing and coding. 5% + Escalate issues that may prevent ... through telephone calls, payer website, and written communication to ensure accurate processing of claims . 15% + Follows established procedure for missing… more
- Molina Healthcare (Buffalo, NY)
- …concisely, accurately and in accordance with regulatory requirements. * Researches claims processing guidelines, provider contracts, fee schedules and systems ... or equivalent combination of relevant education and experience. * Health claims processing experience, including coordination of benefits (COB), subrogation… more
- Molina Healthcare (Buffalo, NY)
- …is likely to be made, to ensure medical necessity and appropriate/accurate billing and claims processing . + Reevaluates medical claims and associated records ... care. **ESSENTIAL JOB DUTIES:** + Facilitates clinical/medical reviews of retrospective medical claim reviews, medical claims and previously denied cases in… more
- Mount Sinai Health System (New York, NY)
- …processes, and related regulations. ? Familiarity with contract terms, NYS regulations, claims processing , and healthcare reimbursement models. ? Experience in ... working with insurance plans and understanding of claim adjudication processes. Non-Bargaining Unit, E01 - Partner MSO...to ensure proper interpretation and application of terms during claims processing . * Ensure that all contract… more
- Rochester Regional Health (Rochester, NY)
- …and authorization details. + Respond to patient complaints by researching coverage and claim processing to ensure the patient responsibility is accurate. Contact ... effectively and accurately managing a receivable. Resolve edits to ensure accurate claims are sent to primary and secondary insurances. Research and resolve denials… more
- Robert Half Accountemps (Rochester, NY)
- …and authorization details. Respond to patient complaints by researching coverage and claim processing to ensure the patient responsibility is accurate. Contact ... by effectively and accurately managing receivables. Resolve edits to ensure accurate claims are sent to primary and secondary insurances. Research and resolve… more