- Excellus BlueCross BlueShield (Rochester, NY)
- …to business analysis. . Intermediate knowledge of PC, software, auditing tools and claims processing systems. Level II (in addition to Level I Qualifications) ... to Level II Qualifications) . Eight (8) years' experience in claims auditing, quality assurance, or recovery auditing, of (MS/APR) DRG coding for hospital… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …in a clear and concise manner. + Analyzes proactive detection reports and claims data to identify red flags/aberrant billing patterns. + Manages cases as assigned, ... and required. + Performs other functions as assigned by management. Level II (in addition to Level I Accountabilities) + Performs more complex investigations… more
- Stony Brook University (East Setauket, NY)
- …support day-to-day business functions including but not limited to: billing, claims analysis appeals, follow-up, financial assistance and customer service. **Duties ... are not limited to:** + Prepare and submit hospital claims . Review denials. Investigate coding issue. Audits. + Follow-up...business experience, preferably in a healthcare setting; **or** an Associate 's degree and at least 6 months of business… more
- Guidehouse (New York, NY)
- …this position include: + Responsible for the daily resolution of assigned claims with applicable Revenue Integrity pre-bill edits and/or specific Revenue Integrity ... and associated coding modifiers. + Responsible for daily resolution of assigned claims with Revenue Integrity specific denials in the Guidehouse METRIX℠ system. +… more