- Molina Healthcare (NY)
- …credentialing database necessary for processing of recredentialing applications. * Reviews claims payment systems to determine provider status, as necessary. * ... Completes follow-up for provider files on 'watch' status, as necessary, following department guidelines and production goals. * Reviews and processes daily alerts for federal/state and license sanctions and exclusions reports to determine if providers have… more
- University of Rochester (Rochester, NY)
- …for non-routine letters of correspondence related to appeals on denied claims , including compiling all necessary information and drafts for provider signature. ... + Manages provider(s) documentation and information. + Composes and types of non-routine correspondence providing factual information. + Arranges travel, conference registration, and hotel accommodations. Interfaces with organizations, hospitals, and others to… more
- Acosta Group (Middletown, NY)
- …to perform the essential duties. _Responsibilities With Regard to Workers' Compensation Claims :_ You are responsible for reporting all employment related injury you ... incur to your direct supervisor as soon as possible following an incident resulting in an injury. **QUALIFICATIONS** _Education/Experience:_ High school diploma or general education degree (GED); or one to three months' related experience and/or training; or… more
- WTW (New York, NY)
- …Risk, including adjustments for model limitations, near-term climate conditions, and claims experience. + Working with clients, jointly with other Willis commercial ... teams, on advisory projects, especially when these require leading-edge research to be applied, or expert judgement. + Creating and giving presentations to clients, for example on model evaluation findings or the impacts of climate change on natural… more
- University of Rochester (Rochester, NY)
- …signatures for non-routine letters of correspondence related to appeals on denied claims . This includes compiling all necessary information and drafts for provider ... signature. - Manages provider(s) documentation and information. Composes and types non routine correspondence providing factual information. - Arranges travel, conference registration and hotel accommodations. Interfaces with organizations, hospitals and… more
- Paychex (West Henrietta, 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. Builds knowledge of the organization, processes, and customers. Responsibilities + Delivers quality service to Paychex clients via phone, email, chat, and other avenues + Follows up on outstanding items to issue completion in… more
- KPH Healthcare Services, Inc. (Gouverneur, NY)
- …monthly, quarterly, and annual management reports for PBM clients, and from our Claims Processor. + Assist with on-site client orientation, health fairs and business ... work shifts. Connect With Us! (https://kphcareers-kphhealthcareservices.icims.com/jobs/14888/senior-customer-service-training- specialist /job?mode=apply&apply=yes&in\_iframe=1&hashed=-336031866) **Job Locations** _US-NY-Gouverneur_ **Posted… more
- Mount Sinai Health System (Elmhurst, NY)
- …information from the accounts receivable team to ensure the time processing of claims and all revenue is captured. Maintains daily logs of coded work. Assures ... that operative reports and other third party regulatory information are pertinent to coding requirements. Works with management and the billing vendor daily, on edit list and/or requests for additional information as to reduce denials and accounts receivable.… more
- University of Rochester (Rochester, NY)
- …which have not been collected through routine billing and collection activities. Claim Resolution Rep III will make independent decisions as to the processes ... necessary to collect denied insurance claims , no response accounts, and will investigate resolving billing...to the attention of billing Manager and Supervisor. The Claim Resolution Rep III will represent the department and… more
- Allied Universal (Batavia, NY)
- … with red flags that suggest fraudulent behavior In relation to an Insurance claim . The SIU Specialist must use their extensive knowledge of Insurance policies ... Company Overview: Advance Your Career in Insurance Claims with Allied Universal(R) Compliance and Investigation Services....Fraud Claim Law Associate (FCLA) + Fraud Claim Law Specialist (FCLS) + Certified Protection… more