- Molina Healthcare (Albany, NY)
- …member eligibility and covered benefits, Provider Portal, and status of submitted claims . * Ability to effectively communicate in a professionally setting. **Job ... Qualifications** **REQUIRED EDUCATION** : HS Diploma or equivalent combination of education and experience **REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES** : 1-3 years Sales and/or Customer Service experience in a fast paced, high volume environment… more
- Molina Healthcare (Albany, NY)
- …setting. **Required Experience** + 3 - 5 years customer service, provider service, or claims experience in a managed care setting. + 3-5 years' experience in managed ... healthcare administration and/or Provider Services. + 5 years' experience in provider contract negotiations in a managed healthcare setting ideally in negotiating different provider contract types, ie, physician, group and hospital contracting, etc. + Working… more
- Molina Healthcare (Rochester, NY)
- …pharmacy prior authorization requests and/or appeals. + Explains Point of Sale claims adjudication, state, NCQA, and CMS policy/guidelines, and any other necessary ... information to providers, members, and pharmacies. + Assists with clerical services/tasks and other day-to-day operations as delegated. + Effectively communicates plan benefit information, including but not limited to, formulary information, copay amounts,… more
- Paychex (Rochester, NY)
- …prescribed guidelines to ensure good customer relations are maintained and customer claims and complaints are resolved fairly, effectively, and in accordance with ... Paychex policies and procedures. Responsibilities + Delivers quality service to Paychex clients via phone, email, chat, and other avenues + Follows up on outstanding items to issue completion in compliance with established Service Level Agreements + Uses… more
- Paychex (Rochester, NY)
- …multiple Paychex products. Ensures good customer relations are maintained and customer claims and complaints are resolved fairly, effectively and in accordance with ... Paychex policies and procedures. Proactively educates and informs clients, and initiates improvements based on client feedback. Has in-depth knowledge of at least one Paychex product. Solves complex problems; takes a new perspective on existing solutions. Acts… more
- University of Rochester (Rochester, NY)
- …accounts, check claim status on appropriate payer systems or contact an insurance representative to obtain information as to why claims are not paid and ... companies to determine reason for claim denial or reason for unpaid claim . Address unpaid claims , and solicit a payment date from the payer. - - - Research… more
- University of Rochester (Rochester, NY)
- …accounts, check claim status on appropriate payer systems or contact an insurance representative to obtain information as to why claims are not paid and ... to determine reason for claim denial or reason for unpaid claim . Address unpaid claims , and solicit a payment date from the payer. + Research and calculate… more
- Gerber Collision & Glass (Albany, NY)
- …to make decisions. You control your future. Job Description: Glass America Customer Service Rep / Admin Support Albany, NY Glass America is a respected leader in the ... auto glass industry. As a Claim Specialist, you are a key member of Glass...+ Have a sense of urgency when filing insurance claims with and/or without customers on the line. +… more
- The Institute for Family Health (New Paltz, NY)
- …on annual changes. + May be responsible for Claim Printing/Reviewing of printed claim forms for accuracy to ensure claims are paid timely. + Maintains ... standards, objectives and policies of the Department and the Organization. The representative shall have a basic understanding of medical billing and collections and… more
- Whitsons Culinary Group (Islandia, NY)
- …the support they need, while driving cost-effective, compliant, and proactive claims management. If you're passionate about building safer environments, protecting ... everything you do. + Lead the full lifecycle of workers' compensation claims -from first report of injury through closure-ensuring accuracy, compliance, and timely… more