- MVP Health Care (Rochester, NY)
- …requires innovative thinking and continuous improvement. To achieve this, we're looking for a Claims Examiner to join #TeamMVP. If you have a passion for medical ... claims and attention to detail this is the opportunity...responsibilities:** + Using a PC /Microsoft Window environment, adjudicates claims with the aid of the Facets and Macess… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …management. Level II (in addition to Level I Accountabilities) * Resolves moderately complex claims processing and claims history audits. * Manages a ... Level III (in addition to Level II Accountabilities) * Performs complex claims processing , claims history audits and policy interpretation, ensuring all… more
- CDPHP (Latham, NY)
- …preferred. Strong PC skills and Microsoft Windows and working knowledge with on-line claims processing and procedural review highly preferred. + Experience with ... ability to determine, analyze and solve problems related to benefits, claims appeals, claims pricing/ processing by utilizing all applicable databases to make… more
- Axis (New York, NY)
- …to resolve complex or contentious claims . Leading initiatives to enhance claims processing efficiency and accuracy within the team. Providing expert opinions ... adept at creating and directing the development of training materials relevant to claims processing . Show a commitment to continuous professional development in… more
- MetLife (Oriskany, NY)
- …to the Beneficiary. May also be responsible for setting up new claims , processing incoming mail, and handling expired call-ups. Principal Responsibilities: ... e-mail for communication with agencies/OFEGLI staff and managers. 8. Processing incoming mail for new and existing claims... Processing incoming mail for new and existing claims . 9. Write manual letters and correspondence on FEGLI… more
- Molina Healthcare (Buffalo, NY)
- …with the member enrollment, provider information management, benefits configuration and claims processing teams to appropriately address provider claim issues. ... Job Summary Respond to inbound calls to provides support for provider claims adjudication activities including responding to providers to address claim issues, and… more
- Humana (Albany, NY)
- …based on business needs. **Preferred Qualifications** + Bachelor's Degree + Prior claims processing experience + Overpayment experience + Financial recovery ... part of our caring community and help us put health first** The Bilingual Claims Research & Resolution Representative 2 manages claims operations that involve… more
- Molina Healthcare (Syracuse, NY)
- …role is involved in member enrollment, provider information management, benefits configuration and/or claims processing . + Assists in the reviews of state or ... **Job Summary** Respond to inbound calls to provides support for provider claims adjudication activities including responding to providers to address claim issues,… more
- Sedgwick (Albany, NY)
- …expertise preferred. **Skills & Knowledge** + Subject matter expertise in worker's compensation claims and/or liability claims processing + Ability to obtain ... a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Complex Claims Advisor | Commercial GL and Auto | Remote Are you looking for an… more
- Albany Medical Center (Albany, NY)
- …Knowledge in billing codes and EDI requirements. Knowledge of electronic claims processing and edits. Excellent decision-making skills, detail oriented, ... + Knowledge in billing codes and EDI requirements. + Knowledge of electronic claims processing and edits. + Excellent decision-making skills, detail oriented,… more