- WSP USA (New York, NY)
- …contractors and commit the SCA's resources on such change orders + Review contractors claims or disputed work and advise senior management as to appropriate ... and problems raised in field reports made by architects and construction management staff. + Work with architect/engineer of record regarding change orders,… 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...clarifies billing issues, payment variances, and/or trends that require management intervention. + Assists department leadership with credit balances… 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...clarifies billing issues, payment variances, and/or trends that require management intervention. Assists department leadership with credit balances account… 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
- Syracuse Community Health Center (Syracuse, NY)
- POSITION SUMMARY: The denials management specialist role involves analyzing, resolving, and preventing denied insurance claims within the Epic electronic health ... Medical Terminology required. Demonstrated understanding of billing requirements for claims , demonstrated knowledge of healthcare insurer reimbursement systems, payer… more
- Molina Healthcare (Yonkers, NY)
- **Job Summary** This position is responsible for the holistic management of the external vendor relationships for Claims and Enrollment activities (along with ... forecast funding needs, and evaluate ROI on the covered benefits and its management + Oversees vendor performance, compliance, and satisfaction, with a focus on… more
- Molina Healthcare (Rochester, NY)
- …execute effective Payment Integrity strategies through both pre-payment and post payment claims reviews, aligning with industry and corporate standards as well as ... Clinician. This includes assessing medical documentation, itemized bills, and claims data to ensure appropriate payment levels, optimize resource utilization,… more
- University of Rochester (Albany, NY)
- … Claims Resolution Representative III reports to Accounts Receivable Management . **ESSENTIAL FUNCTIONS** With general direction of the Manager/Supervisor/Lead: + ... individual, and internal equity considerations._ **Responsibilities:** GENERAL PURPOSE The Claims Resolution Representative III is responsible for working across the… more
- Travelers Insurance Company (Melville, NY)
- …obtaining and reviewing appropriate records and damages documentation. + Keeps effective diary management system to ensure that all claims are handled timely. At ... and resolving assigned General Liability related Bodily Injury and Property Damage claims . Provide quality claim handling throughout the claim life cycle (customer… 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 ... the following, but are not limited to:** + Prepare and submit hospital claims . Review denials. Investigate coding issue. Audits. + Follow-up on rejected or denied… more