- CVS Health (Albany, NY)
- …inquiries and problems. **Additional Responsibilities:** Reviews pre-specified claims or claims that exceed specialist adjudication authority or ... day. **Position Summary** Reviews and adjudicates complex, sensitive, and/or specialized claims in accordance with plan processing guidelines. Acts as a subject… more
- Molina Healthcare (Rochester, NY)
- …Partners to ensure resolution within 30 days of error issuance. * Evaluates the adjudication of claims using standard principles and state specific policies and ... clear and concise to ensure accuracy in auditing of critical information on claims ensuring adherence to business and system requirements of customers as it pertains… more
- Datavant (Albany, NY)
- …and life experiences to realize our bold vision for healthcare. The Specialist is responsible for identifying, analyzing, and resolving claim denials across the ... practices, and proficiency in multiple electronic systems and software tools. The specialist serves as a key liaison between coding, billing, utilization review,… more
- University of Rochester (Rochester, NY)
- …independent decisions as to the processes necessary to collect denied insurance claims , no response accounts, and will investigate resolving billing issues. Maintain ... limited to: telephone, photocopy machine, adding machine, personal computer (for claims inquiry and entry software) fax/scanner, Microsoft Word, Excel, Access,… more