- Molina Healthcare (NY)
- …statuses and risks, and facilitating calls with cross-functional teams + Claims processing , provider contacting, health data analysis and reporting, ... rejection inventory, and works with other areas including IT, health plan, claims , provider, enrollment, regulators, and external vendors, as needed, to remediate… 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
- Independent Health (Buffalo, NY)
- …Reliance Rx Operations & Compliance department. + Experience working with online claims processing system preferred. + Effective oral and written communication ... primarily responsible for completing the billing of both pharmacy and medical claims and adjudicating rejections. **Qualifications** + High school diploma or GED… 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
- 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
- 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
- Westchester Jewish Community Services (White Plains, NY)
- …Care, Medicaid and 3rd Party Insurance. This position ensures timely and accurate processing of claims , collections, and account reconciliations to support the ... billing for Managed Care, Medicaid, and Third-Party Payers, ensuring timely claim submission, editing, transmission, and verification. + Post insurance carrier… more
- Sunrise Senior Living (Glen Cove, NY)
- …internal business controls. + Process and manage unemployment and worker's compensation claims and update claim activity as necessary. + Clearly communicate ... Process payroll and follow established business processes and "Do It Daily" processing activities and submit accurate bi-weekly payroll by established schedule. +… more
- Guthrie (Binghamton, NY)
- …preferred. Knowledge of computer applications (such as Microsoft word processing and spreadsheets) desirable Education/License Current RN licensure required in ... others to ensure consistent and accurate patient status determinations for appropriate claim submission. 3. Participate in UR Committee and UM activities. 4. Assist… more
- Highmark Health (Albany, NY)
- …analytical and communication skills Preferred + Associate's Degree + 3 years with claims processing and data management + Past auditing and strong ... and ensures compliance with DRG/APC structure and regulatory requirements. Performs periodic claim form reviews to check code transfer accuracy from the abstracting… more
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