- 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
- Molina Healthcare (Yonkers, NY)
- …payment methodology & processing is essential + Understanding on hospital claims processing and configuration works + Medicare fee schedule knowledge is ... maintain contract, benefit or reference table information into the claim payment system and other applicable systems. + Participates...**Required Experience** 5-7 years in SQL, Medicare, Networx, QNXT, claims processing and hospital claims … more
- Molina Healthcare (Rochester, NY)
- …and test assumptions through data, and leads with contextual knowledge of claims processing , provider contracts, and operational realities. * Creates succinct ... all payment integrity (PI) solutions. * Independently leads efforts to improve claim payment accuracy, claim referrals, adjustment analysis and financial… more
- Molina Healthcare (Syracuse, NY)
- …Networx. + Experience with QNXT is preferred. + Advanced experience using a claims processing system. + Advanced experienced verifying documentation related to ... * Applies experience and knowledge to research and resolve claim /encounter issues and pended claims , and updates...updates/changes within a claims processing system. + Advanced experience validating… more
- Charles B. Wang Community Health Center (Queens, NY)
- …+ Maintain record of claims & payments + Maintain and report monthly statistics + Monitor denied claims processing + Perform other duties as assigned ... The Biller ensures accurate processing of medical claims using the...improving the overall patient experience. Responsibilities : + Handle claims : filing claim forms and posting payments… more
- Richmond Community Services (Mount Kisco, NY)
- …& Compliance Tasks: You will ensure all deadlines are met by processing invoices, managing claims , submitting reports, and handling any unemployment ... medical, dental, life, and disability benefits. This includes calculating and processing monthly premiums, handling invoices, and generating reports for various… more
- Cardinal Health (Albany, NY)
- …reviewing, and transmitting claims using billing software including electronic and paper claim processing + Following up on unpaid claims within standard ... for verifying patient insurance and benefits, preparing and submitting claims to payers, correcting rejected claims , following...and submitting claims to payers, correcting rejected claims , following up on unpaid and denied claims… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …. Ensures accurate payment by independently utilizing DRG grouper, encoder, and claims processing platform. . Manages case volumes and review/audit schedules, ... business analysis. . Intermediate knowledge of PC, software, auditing tools and claims processing systems. Level II (in addition to Level I Qualifications) .… more
- Excelsior Orthopaedics Group (Amherst, NY)
- …will be responsible for processing the full lifecycle of medical claims -from charge entry and claim submission to payment posting, denial management, ... team focused, service driven, accountable, and innovative every day. + Track claim status using payer portals and billing software; investigate and resolve… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …documentation and communication with Insured, Insured's family, care providers, and monitoring of claim submission and processing . All work is directed under the ... of services as is deemed necessary. + Evaluates submitted claims to determine if services billed and provided are...insurance contract. + Reviews the Insured's benefit file and claim payment to encourage timely submission and adjudication of… more