- University of Rochester (Rochester, NY)
- …Re-submits claims that fail third party edits and submits second level claims . Provides guidance and support to Billing Assistant and answers correspondence. ... Documents all actions thoroughly in visit notes. 30% Corrects claim errors returned post-submission. + Reviews claims ...5% Other duties as assigned: + Provides guidance and support to Billing Assistants + Manually keys/ enters late… more
- University of Rochester (Rochester, NY)
- …to insurance companies 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 underpaid or overpaid claims ; determine final resolution.- - - Re-calculate ...Create - and Make the World Ever Better. In support of our values and those of our society,… 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
- University of Rochester (Rochester, NY)
- …**Responsibilities:** GENERAL PURPOSE With considerable latitude for independent judgment, the Claim Resolution Rep IV is responsible for the follow up and ... point person for complex accounts. Serves as main point of contact in claim resolution process for Strong Memorial Hospital (SMH) clinical staff and outside agencies… more
- Molina Healthcare (Syracuse, NY)
- …Summary** We are seeking a highly experienced Lead Analyst, Configuration Oversight to support our Payment Integrity and Claims Operations teams in ensuring the ... accuracy and compliance of Coordination of Benefits (COB) claim pricing and processing. This role will focus on...guidance. The ideal candidate will bring deep knowledge of claims adjudication, QNXT system navigation, and strong analytical acumen.… more
- University of Rochester (Rochester, NY)
- …to insurance companies 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 underpaid or overpaid claims ; determine final resolution.- - - Re-calculate ...Create - and Make the World Ever Better. In support of our values and those of our society,… more
- University of Rochester (Albany, NY)
- …pertain to claim processing and coding. Escalates system issues preventing claims submission and follow-up for review and resolution. + 5% Collaborates with ... individual, and internal equity considerations._ **Responsibilities:** GENERAL PURPOSE The Claims Resolution Representative III is responsible for working across the… more
- New York State Civil Service (Albany, NY)
- …a lead role in Project Controls functions of claims management, claims negotiation, and litigation support on complex capital construction projects with ... environmental issues and other non-traditional project variables. Essential FunctionsDevelop claims strategies as needed on projects. Oversee analysis of … more
- GE Vernova (Schenectady, NY)
- … in accordance with contract terms and internal policies. + Lead and support continuous improvement initiatives to enhance claim processing efficiency and reduce ... (NAM) region. In this role, you will manage warranty claims with a focus on reducing cycle time, ensuring...timely processing and closure. + Drive reduction in warranty claim cycle time by identifying and eliminating process inefficiencies.… more
- University of Rochester (Rochester, NY)
- … to obtain and verify insurance coverage. + Follows up on unpaid accounts working claims . + Reviews reasons for claim denial. + Reviews payer website or contacts ... open account receivables to successful closure. Responsible for an effective claims follow-up to obtain maximum revenue collection. Researches, corrects, resubmits … more