- MetLife (Oriskany, NY)
- …. Identify and obtain missing information required to evaluate FEGLI life claims and input information into a Power Builder computer claim system computer ... . Interpret policy provisions and manually adjudicate FEGLI Life claims to make claim determinations. . Work with our...thoroughly. . Actively pursue and follow up on open claims within specified timeframe. . Manage and organize work… more
- Travelers Insurance Company (Melville, NY)
- …evaluating, reserving, negotiating and resolving assigned serious and complex Specialty claims . Provides quality claim handling throughout the claim life cycle ... **What Will You Do?** + Directly handle assigned severe claims . + Full damage value for average claim (without...several million dollars, amounting to a typical inventory of claims with FDV of over a multi-million dollar value.… more
- Mount Sinai Health System (New York, NY)
- …to Directors for potential legal intervention, and assisting in the escalation of claims that may require involvement from insurance carriers or legal entities. The ... cycle management, with a strong understanding of both hospital and professional claims processes. * Previous experience in a role that involved analyzing contracts,… more
- University of Rochester (Rochester, NY)
- …open account receivables to successful closure. Responsible for an effective claims follow-up to obtain maximum revenue collection. Researches, corrects, resubmits ... claims , submits appeals and takes timely and routine action to resolve unpaid claims . Resolves complex claims . Acts as a resource for lower-level staff.… more
- Sedgwick (Rochester, NY)
- …- Hybrid **PRIMARY PURPOSE** : To analyze complex or technically difficult general liability claims to determine benefits due; to work with high exposure claims ... involving litigation and rehabilitation; to ensure ongoing adjudication of claims within service expectations, industry best practices and specific client service… more
- New York State Civil Service (Albany, NY)
- …Manager, Cost Control takes a lead role in Project Controls functions of claims management, claims negotiation, and litigation support on complex capital ... environmental issues and other non-traditional project variables. Essential FunctionsDevelop claims strategies as needed on projects. Oversee analysis of … more
- University of Rochester (Albany, NY)
- …open account receivables to successful closure. Responsible for an effective claims follow-up to obtain maximum revenue collection. Researches, corrects, resubmits ... claims , submits appeals and takes timely and routine action to resolve unpaid claims . Resolves complex claims . Acts as a resource for lower level staff.… more
- University of Rochester (Rochester, NY)
- …independent decisions as to the processes necessary to collect denied insurance claims and resolve billing issues. Must track payer/billing issues that affect ... reimbursement of claims and advising the management team of those trends...third-party payers to obtain payments, research, and resubmit rejected claims to primary payers, obtain and verify insurance information.… more
- University of Rochester (Rochester, NY)
- …independent decisions as to the processes necessary to collect denied insurance claims and resolve billing issues. Must track payer/billing issues that affect ... reimbursement of claims and advising the management team of those trends...to: telephone, photocopy machine, adding machine, personal computer (for claims inquiry and entry software), fax, scanner, EPIC billing… more
- Molina Healthcare (Syracuse, NY)
- …Lead Analyst, Configuration Oversight to support our Payment Integrity and Claims Operations teams in ensuring the accuracy and compliance of Coordination ... and regulatory guidance. The ideal candidate will bring deep knowledge of claims adjudication, QNXT system navigation, and strong analytical acumen. Experience in… more