- Healthfirst (NY)
- …working with health plan operations and IT + Experience working as a project manager in a healthcare setting + Experience with adult learning and development + ... Exposure to claims , provider payment, provider onboarding, or contracting operations within a healthcare payor environment. WE ARE AN EQUAL OPPORTUNITY EMPLOYER.… more
- Evolent (Albany, NY)
- …for the culture. **What You'll Be Doing:** **Job Summary:** The **Software Engineering Manager ** at Evolent will lead a team of software/data engineers in designing, ... as HIPAA, as well as healthcare systems and domains (FHIR/HL7, EMR/EHR, Claims , Members, Providers, Payors, etc.). + Experience with designing and implementing… more
- University of Rochester (Rochester, NY)
- …and adjudication, including refund of credits - - Review and advise supervisor or manager on trends of incorrectly paid claims from specific payers - - ... as to the processes necessary to collect denied insurance claims and resolve billing issues. Must track payer/billing issues...tasks, following standard procedures, and as directed by the Manager , Billing or Manager . Independent judgement is… more
- Aston Carter (New York, NY)
- …internal finance teams. + Validate and process timesheets, invoices, and expense claims . + Respond to contractor inquiries regarding payments and invoices. + Track ... payroll metrics and maintain accurate records. + Collaborate with HR and Finance to ensure compliance with US payroll laws and multi-state regulations. Essential Skills + Experience in staffing, recruitment, or contractor-heavy environments, specifically… more
- Insight Global (New York, NY)
- …support a large body of work for the Dispute teams back-office operations. The claims agents use Pega Dispute as their platform to manage credit card disputes and ... chargebacks between all parties. Pega is integrated with Mastercard and currently consists of many dispute processing workflows that are manual and require optimization. The goal of this position is to drive automations in these Pega and chargeback related… more
- Tompkins Community Bank (Batavia, NY)
- …the billing procedure for account transactions + Provide assistance to customers reporting claims + Review and maintain current ImageRight "To Do List" + Identify ... and offer to customer account rounding and up selling opportunities + Provide administrative support as requested by Producers and other staff members + Additional duties as assigned by Management Qualifications + Two year college degree in related field or… more
- Highmark Health (Albany, NY)
- …for non-payment, Completing write-offs as appropriate, Coordinating AR issues affecting claims or inquiry processing with Membership and Billing personnel.Lead or ... participate in higher level AR tasks and projects, typically related to: Analysis and reconciliation of cash in transit discrepancies, Streamlining, development and documentation of AR policies or procedures, Reduction of AR balances and coordination of… more
- Arnot Health (Elmira, NY)
- …information to appropriate billing clerks and management. 6. Follow up on denial claims using reports to ensure completion of appeal with other department staff 7. ... Interacts with physicians and other Arnot Health departments in matters of auth/denial review decisions. 8. Maintains a working relationship with Physician Advisor regarding physician issues related to auths/denials. 9. Provide insurance companies with… more
- Molina Healthcare (Buffalo, NY)
- …rejections. Address a variety of enrollment questions or concerns received via claims , call tracking, or e-mail. Maintain records in the enrollment database. ... **Knowledge/Skills/Abilities** + Has direct oversight of enrollment, premium billing and reconciliation processes and all related staff + Coaches and mentors direct staff, including goal setting and score card development + Monitors and enforces compliance… more
- World Insurance Associates, LLC. (Webster, NY)
- …excellent service, and professional communication + Handling renewals, service requests, claims , billing and new policies. This includes marketing of renewal ... business + Maintain a thorough understanding of the markets and their appetites, underwriting guidelines, submitting and procedures + Review all applications, policies, endorsements and audits for accuracy + Complete loss/claim analysis and summaries… more