- SUNY Upstate Medical University (Syracuse, NY)
- …inbound inquires related to prior authorizations and assists billing group on insurance claims . Completes outbound calls to payors and clinics to assist with prior ... authorizations. + Verifies insurance coverage related to prior authorizations by phone, online or through E1 (electronic system) transactions for all new patients and/or changes in coverage. + Enters patient insurance information under the patient's account in… more
- The Institute for Family Health (New Paltz, NY)
- …and facilitates resolution. + May be responsible for Claim Printing/Reviewing of printed claim forms for accuracy to ensure claims are paid timely. + May be ... that processing of denials are at optimal levels + Ensure daily/weekly/monthly medical claim submission. Resolve claim and remittance file issues as needed. +… more
- Allied Universal (Staten Island, 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 ... 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
- CDM Smith (Albany, NY)
- …**Business Unit:** FSU **Job Description:** CDM Smith is seeking a Forensic Accounting Specialist with expertise in disaster fraud claims . This role is critical ... in evaluating and analyzing financial data related to disaster-related claims , including property damage, business interruption, and other loss categories. The … more
- City of New York (New York, NY)
- …medical records requests from MCO to obtain prior authorization approvals and claim reimbursement. - Review all claims CPT/ICD-10/HCPCS, payment modifiers in ... Billing by working alongside a team of talented health insurance billing specialist , you will perform health insurance billing activities and support functions… more
- Molina Healthcare (Albany, NY)
- …and executing operational initiatives tied to Payment Integrity (PI) and provider claims accuracy. The individual will be relied upon to make independent, informed ... for all PI solutions. + Lead efforts to improve claim payment accuracy, claim referrals, adjustment analysis...a business lens to ensure accurate interpretation of provider claims trends, payment integrity issues, and process gaps. +… more
- City of New York (New York, NY)
- …TO BE CONSIDERED FOR THIS POSITION CANDIDATE MUST BE SERVING PERMANENTLY IN THE TITLE OF CLAIM SPECIALIST , OR REACHABLE ON THE CLAIM SPECIALIST CIVIL ... SERVICE LIST, OR ELIGIBLE UNDER THE 55A PROGRAM. CLAIM SPECIALIST - 30726 Qualifications 1. A...two years of full-time satisfactory experience investigating and/or settling claims for personal injury or property damage or loss;… more
- Catholic Health (Buffalo, NY)
- …legal field preferred + Certified Case Manager (CCM), Certified Disability Management Specialist (CDMS), and/or claim adjuster licensure preferred EXPERIENCE + ... (IDM) position is responsible for monitoring and aggressively managing claims leaves, and absences associated with occupational and non-occupational injury… more
- Cardinal Health (Albany, NY)
- …skills and prioritizes getting the right things done. **The Accounts Receivable Specialist II is responsible for processing insurance claims and billing. ... and support from AR & Billing leadership teams.** **_Responsibilities_** + Processes claims : investigates insurance claims ; and properly resolves by follow-up &… more
- Molina Healthcare (Syracuse, NY)
- …and executing operational initiatives tied to Payment Integrity (PI) and provider claims accuracy. The individual will be relied upon to make independent, informed ... SAI targets are met. + Leads efforts to improve claim payment accuracy and financial performance without needing extensive...a business lens to ensure accurate interpretation of provider claims trends, payment integrity issues, and process gaps. +… more