- Humana (Albany, NY)
- …outcomes. **Key Responsibilities:** + Lead large-scale product efforts focused on improving claims processing and related systems, ensuring these efforts support ... with special attention to privacy, security, and regulatory requirements in claims processing . + Act as an escalation point for critical delivery blockers… more
- Mount Sinai Health System (New York, NY)
- …required. Familiarity with CPT and ICD (coding and CCI edits) + Electronic claims processing preferred. **Responsibilities** 1. Follows up on submitted claims ... secondary balances to appropriate financial class and provides documentation for processing the claims . 6. Reviews Credit Letter Sent (CLS) and transfers balance… more
- Intermountain Health (Albany, NY)
- …guidelines + Responsible for primary oversight of revenue cycle functions such as claims processing , denials, payments, customer service, and follow up on ... or commercial payer enrollments for both technical and/or professional fee claim reimbursement. Assist in minimizing provider enrollment AR by monitoring enrollment… more
- Hannaford (Highland, NY)
- …forms after prescriptions are dispensed. * Prepare and complete manual insurance claim forms if needed. * Maintain organized filing system for invoices, manual ... insurance claims , daily reports, etc.. in accordance with Standard Practice...Relay specific communications to customer from technician or pharmacist processing prescription. * Maintain solid communication within the department.… more
- KPH Healthcare Services, Inc. (East Syracuse, NY)
- …refund requests + Complex account reconciliation + Account adjustments, bad debt processing + Third party, Medicare, Managed Care, and private billing, claim ... + Track and re-bill pending Medicaid accounts + Re-bill claims as needed + Identify pattern problems (improper patient...and private pay + Month-end closing process + Re-bill claims to improve reimbursement from NETRX reporting + Assist… more
- City of New York (New York, NY)
- …and claiming data for data entry into multiple database systems for agency claims submitted annually for Federal and State reimbursement. - Analyze fiscal year ... claims , revenue, invoices and payment vouchers to ensure alignment...monthly Expense, Payment and Claiming reports to ensure accurate processing . Analyze, review and provide recommendations for Agency Program… more
- Hannaford (Gloversville, NY)
- …forms after prescriptions are dispensed. * Prepare and complete manual insurance claim forms. * Maintain organized filing system for invoices, manual insurance ... claims , daily reports, etc. in accordance with Standard Practice...return pharmacy inventory through proper supplier. * Assist in processing pharmacy outdates and credits including keeping inventory free… more
- Mount Sinai Health System (New York, NY)
- …This role ensures that all team members involved in patient registration, billing, claims processing , denial management, and collections are equipped with the ... and reports. + Strong experience with vendor contract management and invoice processing . **Knowledge, Skills, and Abilities** 1. Demonstrated success in a large… more
- University of Rochester (Rochester, NY)
- …conducts operations that affect the revenue cycle (eg, billing, collections, payment processing ). Develops and implements processes to meet revenue cycle goals in ... + Resolves flagged reports to ensure timely submission of claims to payers. + Monitors and ensures worklists are...timely manner. + Monitors cash flow, receivables, Hold Bills, Claim Edits, and aging reports, as well as payment… more
- Rochester Regional Health (Rochester, NY)
- …actions. RESPONSIBILITIES: + Medical Billing Expertise: Proficient in billing, claims processing (Inpatient, Outpatient, Critical Access, Rural Health), ... terminology, physician fee schedules, DRGs, and reimbursement procedures. + Claims and Appeals Processing : Submits and follows up on insurance claims ;… more