- Planned Parenthood of Central and Western NY (Rochester, NY)
- …Functions 70% Auditing and Corrective Action + Evaluates charge capture, claims scrubbing and sliding fee discount practices to ensure efficiency, accuracy, ... and completeness of encounters, claims and transactions in compliance with payer rules and...+ Recommends modifications to established practices and procedures or system functionality based on findings to improve workflows, to… more
- CVS Health (Albany, NY)
- …related to Network contracts and agreements. + Research identified issues; submit claim adjustment requests and determine the root cause of disputes. + Serve ... and responding to provider participation and pricing inquiries. + Analyze post-paid healthcare claims as it relates to pricing needs. + Apply in-depth research to… more
- City of New York (New York, NY)
- …data warehousing services to constituent divisions of the Finance Office. The Senior Systems Analyst will perform technical and analytical work that will assist the ... Office is seeking an Associate Staff Analyst to function as the Senior Systems Analyst within Management & Policy Research/Single Issue Review unit, who will be… more
- CVS Health (Albany, NY)
- …effective solutions for our patients by billing Home Infusion and DME claims and invoices to governmental and commercial insurance companies for reimbursement for ... our patients' insurance claims . In this role, you will ensure timely and...role, you will ensure timely and accurate review and claim submission on all patient accounts subject to medical… more
- House of the Good Shepherd (Utica, NY)
- …knowledge of county billing regulations, and proficiency in billing software and systems . Job Responsibilities * Prepare and submit accurate billing claims ... with county billing guidelines and regulations. * Monitor the status of contract claims , follow up on outstanding claims , and resolve billing discrepancies or… more
- BronxCare Health System (Bronx, NY)
- …with maintaining and furthering a positive public perception of BronxCare Health System and its employees. - Contributes to and participates in the ... collection, analysis, implementation of and compliance with risk management and claims activities, support of and participation in Continuous Quality Improvement… more
- Brighton Health Plan Solutions, LLC (New York, NY)
- …revenue agencies and other healthcare providers with member benefits, eligibility, claims inquiry, claim reconsiderations and appeals. The Customer Service ... + Handle inbound calls from members, medical providers, and others. + Adjust claims accurately, if needed. + Listen to and address customer needs and concerns… more
- Molina Healthcare (New York, NY)
- …maintain contract, benefit or reference table information into the claim payment system and other applicable systems . + Participates in defect resolution for ... claims databases. Synchronizes data among operational and claims systems and application of business rules...housed on databases and ensure adherence to business and system requirements of customers as it pertains to contracting,… more
- Elderwood (Buffalo, NY)
- …+ Electronic billing of Medicare, Medicaid and Third Party Insurance pharmacy claims utilizing Framework LTC Pharmacy system . + Skilled nursing facility, ... assisted living facility and private pay pharmacy claim billing + Troubleshoot rejected insurance claims ...pharmacy claim billing + Troubleshoot rejected insurance claims resulting in payments + Prior Authorizations required from… more
- BronxCare Health System (Bronx, NY)
- …maintaining and furthering a positive public perception of BronxCare Health System and its employees. 2. Describe responsibility:Contributes to and participates in ... collection, analysis, implementation of and compliance with risk management and claims activities, support of and participation in Continuous Quality Improvement… more
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