- Molina Healthcare (Rochester, NY)
- … claims , COB and DRG/RCC pricing). * Experience with Medicaid and Medicare claims denials and appeals processing , and knowledge of regulatory guidelines for ... JOB DESCRIPTION Job Summary Leads and manages team responsible for claims activities including reviewing and resolving member and provider complaints, and… more
- Hannaford (Guilderland, 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
- New York State Civil Service (Albany, NY)
- …to the Claimant Services Unit and be responsible for reviewing and processing claims , performing database searches using information provided by claimants; ... Duties Description Perform entry-level clerical and office support work, including processing transactions and maintaining records, in a variety of organizational… 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
- Oak Orchard Health (Brockport, NY)
- …cycle operations and liaison with the third-party billing organization to ensure proper processing of all payer claims . This would include research for accuracy, ... the third-party billing company + Manage Accounts Receivable related to all claims and ensure reconciliation with the general ledger. This involves working closely… more
- Mount Sinai Health System (New York, NY)
- …Accounts Receivable, Charge Entry, Edits and Payment Posting. This individual facilitates claims processing and payments services rendered by physicians and ... problem resolution to ensure accurate and timely payment of claims and collection. The Specialist works directly with the...+ 5 years experience in medical billing or health claims , with experience in IDX billing systems in a… more
- City of New York (New York, NY)
- …of medical consultation appropriate to the circumstances of the cases. Reviews claims for processing voluntary awards of workers' compensation benefits. Trains ... 5141. Under direct supervision, receives and processes incoming workers' compensation claims . Performs tasks such as the following: Reviews accident reports and… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …Medicaid, CPT, HCPCS, ICD10, DRG, APC, RBRVS, etc.). + Extensive experience with claims processing systems, claims flow, adjudication process, system edits ... in a clear and concise manner. + Analyzes proactive detection reports and claims data to identify red flags/aberrant billing patterns. + Manages cases as assigned,… more
- City of New York (New York, NY)
- …of Clerical Associates, Eligibility Specialist, and Principal Administrative Associates involved in claim review and processing . - Assign, evaluate and review ... - Liaise with the Social Security Administration on any issues related to the claims or the use of the Government Service Online (GSO) application. Salary Range:… more
- Ellis Medicine (Schenectady, NY)
- …existing structure + Evaluates, designs and implements solutions for accessing, moving, and processing electronic data + Serve as a liaison with medical coding team ... Billing Exception Worklist (EBEW) and related worklists that hold claims from billing, establish and maintain a close working...relationship with the PBO dept. to reduce and address claim issues and denials timely + Conducts training and… more