- GE Aerospace (Schenectady, NY)
- …Microsoft Office Suite and ability to navigate other business-related software, including claim processing systems and applications. + Excellent written and oral ... In this high-impact role, you'll deliver sharp insights, adjudicate complex claims , and collaborate across teams using advanced analytics and emerging technology.… 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
- 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 . ... effectively and accurately managing a receivable. Resolve edits to ensure accurate claims are sent to primary and secondary insurances. Research and resolve denials… more
- Access: Supports For Living (Middletown, NY)
- …identified revenue cycle billing issues + Handling billing cycle review procedures for pre- processing (scrubbing) of weekly claims processing + Analyze, ... throughout the revenue cycle. This individual manages the electronic claims process, including accurate and timely claim ...billing and processing program claims for accuracy and completeness; submit claims … more
- Robert Half Legal (New York, NY)
- …seeking a Claims Technical Specialist to oversee the examination, evaluation, and processing of complex claims estimates and paid claims values, ensuring ... policy terms and conditions in alignment with the client's Claims Philosophy. This role supports the claims ...with laws, regulations, and best practices. + Deliver superior claim outcomes through exceptional customer care and responsiveness. +… more
- Highmark Health (Albany, NY)
- …+ High school diploma or GED + Experience in pharmacy prescription claims processing /submission/payment. **Preferred** + Associate degree + Pharmacy technician ... inquiries concerning oral, injectable and infusion medication requests, and drug claim edits/prior authorizations. By reviewing member claims history, clearly… 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
- Albany Medical Center (Albany, NY)
- …all payor appeals for claim denied erroneously Validate timely resolution of claim errors Validate timely and accurate refund processing Daily monitoring of ... follow up on all outstanding claims Validate timely submission of...all third party payor and federal and state government claim submission regulation Monthly review of chargemaster CPT, HCPCS… more
- Cardinal Health (Albany, NY)
- …+ Mails all paper claims . + Acts as a subject matter expert in claims processing . + Manages billing queue as assigned in the appropriate system. + Manages ... done. **The Accounts Receivable Specialist II is responsible for processing insurance claims and billing. They will...company policy, regulations, or third-party policy. + More challenging claim cases + Investigates and updates the system with… more