- Broadview FCU (Schoharie, NY)
- …place! Overview of Your Role The Personal Lines Customer Service Representative identifies, contacts, and develops prospective insurance clients, and oversees ... to client. + Receive phone calls from clients and companies regarding insurance, claims , or administrative problems, and comply with the request and/or refer to the… more
- Molina Healthcare (Rochester, NY)
- …of pharmacy prior authorization requests and/or appeals. * Explains point-of-sale claims adjudication, state, NCQA and CMS policies/guidelines, and any other ... and appeals. * Records calls accurately within the pharmacy call tracking system . * Maintains established pharmacy call quality and quantity standards. * Interacts… more
- University of Rochester (Rochester, NY)
- …software) fax/scanner, Microsoft Word, Excel, Access, Email, third party claims systems (ePaces, Connex), Epic Billing System , and various payer web sites. ... not been collected through routine billing and collection activities. Claim Resolution Rep III will make independent decisions as...Insurance Coverage tab), review payer website, or contact payer representative as to why claims are not… more
- Molina Healthcare (NY)
- …member eligibility and covered benefits, Provider Portal, and status of submitted claims . * Ability to effectively communicate in a professionally setting. **Job ... combination of education and experience **PREFERRED EXPERIENCE** : + 1-3 years + Preferred Systems Training: + Microsoft Office + Genesys + Salesforce + Pega + QNXT… more
- New York State Civil Service (New York, NY)
- …titles include, but are not limited to: Administrative Analyst Trainee 1, Claims Services Representative Trainee 1, Contract Management Specialist Trainee 1, ... NY HELP Yes Agency Insurance Fund, State Title Business Systems Analyst Trainee 1/Trainee 2 - Finance (NY HELPS)...Law. Eligible titles include, but are not limited to: Claims Services Representative 1, Policyholder Services … more
- University of Rochester (Rochester, NY)
- …the individual, and internal equity considerations._ **Responsibilities:** GENERAL PURPOSE The claims resolution representative II is responsible for working ... and taking timely and routine action to resolve unpaid claims . The Claims Resolution Representative ...accounts receivables, making any corrections in the professional billing system necessary to ensure balance resolution for all assigned… more
- MTA (Jamaica, NY)
- …+ A NYC Certificate of Fitness (COF) for a Fire Safety Director, Sprinkler Systems and/or Standpipe system inspection, testing and other maintenance. + A NYS ... Field Engineer Fire Protection Systems Job ID: 11226 Business Unit: Long Island...this 24/7/365 operation served 75.5 million riders on a system that stretches nearly 120 miles - from Penn… more
- Highmark Health (Albany, NY)
- …inquiries concerning oral, injectable and infusion medication requests, and drug claim edits/prior authorizations. By reviewing member claims history, clearly ... + Enter all authorizations into the Argus IPNS information system to allow claim adjudication. + Complete...practices through paid clams review. + Participate as pharmacy representative in onsite member appeals and grievances sessions. +… more
- Mohawk Valley Health System (Utica, NY)
- …- Per Diem Department: PATIENT ACCESS SVCS Job Summary The Patient Financial Representative is responsible for the accurate and timely verification of insurance and ... patient demographic and insurance information is correct, resulting in accurate claims for reimbursement. Position provides excellent customer service during all… more
- CVS Health (Albany, NY)
- …+ Clinical background a plus. + Experience with Aetna and CVS products, claim systems , and digital member applications. + Associate degree or equivalent ... clinical support to members as well as navigating them through the health system , providing support on claims issues, and answering coverage-level questions.… more
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