- CDPHP (Albany, NY)
- …a fast-paced high volume call center preferred. + A background in health insurance claims and appeals processing is preferred. + Experience with a documentation ... be a part of that experience. The Customer Care Representative shall assume full responsibility and ownership for all...to determine, analyze and solve problems related to benefits, claims processing, claims and benefit appeals… 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
- Cardinal Health (Albany, NY)
- …as assigned in the appropriate system. + Manages and resolves complex insurance claims , including appeals and denials, to ensure timely and accurate ... done. **The Accounts Receivable Specialist II is responsible for processing insurance claims and billing. They will work within the scope of responsibilities as… more
- Rochester Regional Health (Rochester, NY)
- …the payer website, coverage policies and/or phone calls to the payer. Submit corrected claims and appeals . + Process account adjustments and refunds as needed ... Job Title: Business Office Representative Department: Billing Location: Riedman Campus SUMMARY: Ensure...managing a receivable . Resolve edits to ensure accurate claims are sent to primary and secondary insurances .… more
- Molina Healthcare (Albany, NY)
- …+ Provides coordination and processing of pharmacy prior authorization requests and/or appeals . + Explains Point of Sale claims adjudication, state, NCQA, ... member and providers with initiating oral and written coverage determinations and appeals . + Records calls accurately in call tracking system. + Maintains specific… more
- Rochester Regional Health (Rochester, NY)
- …the payer website, coverage policies and/or phone calls to the payer. Submit corrected claims and appeals . + Process account adjustments and refunds as needed ... effectively and accurately managing a receivable. Resolve edits to ensure accurate claims are sent to primary and secondary insurances. Research and resolve denials… more
- MTA (Brooklyn, NY)
- …Operating Authority, which includes the New York State Department of Labor claims processing, hearings, appeals , adjournments, remands and quarterly audits. ... tasks are performed correctly and efficiently in compliance with mandated deadlines. Review UI claims before submission to the DOL and also review NF claims … more
- The Institute for Family Health (New Paltz, NY)
- …+ Provides clerical support to senior representatives such as mailing paper claims , preparing spreadsheets for appeals , or maintaining data spreadsheets as ... and policies of the Department and the Organization. The representative shall have a basic understanding of medical billing...patients on daily basis. + Recognizes issues relating to claims denials and communicates such information in a timely… more
- Saratoga Hospital (Saratoga Springs, NY)
- …Financial Services department. What You'll Do + Handle and resolve assigned denied claims in multiple work queues including, but not limited to, eligibility and ... and documents, entering data into the EMR system, assisting in compiling appeals and reconsiderations. + Collaborate and communicate effectively with employees and… more