- 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
- 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
- AECOM (New York, NY)
- …of additional work and potential claims . + Help to prepare and submit claims and claim responses as required. + Management of project tasks, DBE compliance, ... activities. + Identify conditions that could lead to a change orders or claims . + Review contract documents and advise regarding procedures and policy within. When… more
- Cardinal Health (Albany, NY)
- … + Preparing, reviewing and billing claims via electronic software and paper claim processing + Insurance claims follow up regarding discrepancies in ... administration, customer and vendor pricing, rebates, billing (including drop-ships), processing charge backs and vendor invoices, developing and negotiating… more
- FLACRA (Newark, NY)
- …FLACRA's billing and payment collection processes. This position is responsible for processing claims , managing accounts receivable, and ensuring timely and ... up on outstanding balances. + Work with insurance companies to address disputed claims and resolve processing issues. + Maintain and update tracking spreadsheets… more
- Cognizant (Albany, NY)
- …will make an impact by configuring and maintaining QNXT systems to ensure accurate claims processing and compliance with client requirements. You will be a ... + Perform **back-end queries** and validate configuration setups to ensure accurate claim processing . + Advise clients on **configuration decisions** in… more
- City of New York (New York, NY)
- …staff involved in the processing of cases to determine if Food Stamp claims should be initiated. Coordinate and maintain control of the activities of the Special ... responsible specialized administrative work supervising the functions of the City-wide Claims Units and/or supervising the functions of the City-wide Special… more
- City of New York (New York, NY)
- …Bureau of Law and Adjustment (BLA), negotiates and approves all monetary settlement of claims and lawsuits involving the City of New York. BLA investigates and, when ... in the best interest of the city, settles pre-litigation claims for and against the City of New York. In resolving claims before litigation is commenced, BLA… more
- Molina Healthcare (Syracuse, NY)
- …managed care or payer environment. + In-depth knowledge of medical and hospital claims processing , including CPT/HCPCS, ICD, and modifier usage. + Strong ... requirements related to but not limited to coverage, reimbursement, and processing functions to support systems solutions development and maintenance. This role… more
- Otsuka America Pharmaceutical Inc. (Albany, NY)
- …+ Transact and document inventory movements and reconciliations, return and claim approvals, and product destructions. + Manage inventory reporting and communicate ... offered money for equipment fees or some other application processing fee, even if claimed you will be reimbursed,...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more
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