- Molina Healthcare (Buffalo, 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 (NY)
- …pricing configuration, claim adjudication or reimbursement processes + Experience processing or reviewing facility claims + Prior professional experience ... vendor, operations, health plan representatives, and other business teams involved in claim processing . Maintains expertise in all forms of reimbursement… more
- Molina Healthcare (Syracuse, NY)
- …and tests assumptions through data, but leads with contextual knowledge of claims processing , provider contracts, and operational realities. + Creates succinct ... operational initiatives tied to Payment Integrity (PI) and provider claims accuracy. The individual will be relied upon to...SAI targets are met. + Leads efforts to improve claim payment accuracy and financial performance without needing extensive… 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
- ConvaTec (Massapequa, NY)
- …requires some explanation or interpretation. **Key Responsibilities:** + Responsible for claim review and submission to Medicare, Medicaid, commercial and private ... prior to submission. + Follows up with insurance companies on unpaid or rejected claims . Resolves issues and resubmits claims . + Reads and interprets insurance… more
- Lithia & Driveway (Albany, NY)
- …Warranty Experience highly preferred + Experience preparing, recording, and submitting warranty claims + Experience Processing warranty claims on a ... the Warranty Administrator prepares, submits, and tracks warranty repair orders and claims . The Warranty Administrator is responsible for the accuracy and timeliness… 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
- 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
- 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
- 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