- Molina Healthcare (Rochester, NY)
- …processing, including CPT/HCPCS, ICD, and modifier usage. + Strong understanding of claim system configurations, payment policies, and audit processes. + ... not limited to coverage, reimbursement, and processing functions to support systems solutions development and maintenance. This role includes coordination with… more
- Sedgwick (Albany, NY)
- …+ Receives and reviews new claims and maintains data integrity in the claims system . + Reviews survey reports and insurance policies to determine insurance ... Insurance Marine Adjuster **PRIMARY PURPOSE** **:** To investigate and process marine claims adjustments for clients; to handle complex losses locally unassisted up… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …with ICD 10CM, MS-DRG, and APR-DRG with a broad knowledge of medical claims billing/payment systems , provider billing guidelines, medical necessity criteria, and ... analysis. . Intermediate knowledge of PC, software, auditing tools and claims processing systems . Level II (in addition to Level I Qualifications) . Five… more
- Sunrise Senior Living (Hicksville, NY)
- …Resources** + Create and maintain team member personnel information in appropriate systems ; Human Resources Information System (HRIS), timekeeping system , ... controls. + Process and manage unemployment and worker's compensation claims and update claim activity as necessary....reporting. + Perform business processes in the following technology systems : + Billing system . + Time keeping… more
- Midwood EMS (Brooklyn, NY)
- …insurance claim submissions. + Familiarity with ICD-10 coding, DRG systems , and other relevant coding methodologies. + Excellent understanding of medical ... with a strong focus on New York State Medicaid claims . Candidate must be able to work 5 days...for completeness and accuracy before billing. + Utilize coding systems such as ICD-10 for diagnosis coding and DRG… more
- Monro Muffler/Brake (Fairport, NY)
- …Functions: Administrative + Handle sensitive information in a confidential manner. + Inputting claims following the guidelines of Monro Inc. claim programs. + Be ... costs. The Liability Analyst will understand and professionally input and communicate claims to the Risk Management and Monro Inc. leadership Team. Compensation: The… more
- BronxCare Health System (Bronx, NY)
- …collection, analysis, implementation of and compliance with risk management and claims activities, support of and participation in Continuous Quality Improvement ... (CQI) teams, consistent adherence to the specific rules and regulations of the Bronx-Lebanon Hospital Center (a) Safety and Security Policies, (b) Risk Management: Incident and Occurrence Reporting, (c) Infection Control Policies and Procedures and (d) Patient… more
- Ryder System (Albany, NY)
- …years or more experience in employment law. + Experience managing employment claims raised with federal and/or state administrative agencies. **SKILLS & ATTRIBUTES** ... + Exceptional ability to draft comprehensive, concise, and legally sound position statements. + Strong collaboration skills to work effectively with internal stakeholders and gather relevant information/evidence. + Excellent legal judgment, negotiation skills,… more
- BronxCare Health System (Bronx, NY)
- …collection, analysis, implementation of and compliance with risk management and claims activities, support of and participation in Continuous Quality Improvement ... (CQI) teams, consistent adherence to the specific rules and regulations of the Bronx-Lebanon Hospital Center (a) Safety and Security Policies, (b) Risk Management: Incident and Occurrence Reporting, (c) Infection Control Policies and Procedures and (d) Patient… more
- Mohawk Valley Health System (Utica, NY)
- …and uses them as a contact when necessary to resolve outstanding issue on claims . + Determines whether payment from insurance billed is accurate, based on DRG, ... Contracted Rate, Per Diem, or Fee Schedule. Initiates an adjustment, if necessary, to bring account to the correct balance. Demonstrates thorough knowledge of rates for specific payor responsibility and advises management of any trends regarding inappropriate… more