- Intermountain Health (Albany, NY)
- …Maintaining credit resolution vendor relations. Ensuring the accurate and timely processing of patient credits, active participation in system integration testing, ... years of experience in Healthcare Revenue Cycle (Credit Balance/Resolution, Payment Posting, Claims , Billing, and Insurance and Follow-up) . Three (3) years of… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …reports to support initiatives, and changes to process flows. * Reviews complex claims , financial models, test results, and trends with providers and hospital system ... efficiency of team. * Implements recommendations of system enhancements, processing guidelines, system and/or training documentation modifications. Minimum Qualifications:… more
- Molina Healthcare (Buffalo, NY)
- …regulations, NCQA guidelines, and CMS standards. + Provides coordination and processing of pharmacy prior authorization requests and/or appeals. + Explains Point ... of Sale claims adjudication, state, NCQA, and CMS policy/guidelines, and any other necessary information to providers, members, and pharmacies. + Assists with… more
- Colgate-Palmolive (New York, NY)
- …+ Review reports to ensure proper leave coordination and accurate return-to-work processing + Escalate and resolve issues, working with stakeholders to enhance ... (STD, FMLA). + Review payments to prevent overpayments and ensure accurate claims . + Manage and document all return-to-work procedures and address unauthorized… more
- CVS Health (Amherst, NY)
- …accounts and be accountable for open items + Work closely with AR and Claims Teams to successfully integrate and analyze all file feeds from claim systems to ... processes + Other Duties and Responsibilities as assigned. + Claim setup, processing , tracking + Onboarding, maintenance, off boarding of groups + Quality Control… more
- Northwell Health (Lake Success, NY)
- …Warehousing and associated ETL process + Experience working with Payer claims , Billing Data, able to profile, identify data patters, anomalies/inconsistencies in ... with building ETL packages using SSIS + Experience with GCP and its data processing tools will be a plus *Additional Salary Detail The salary range and/or hourly… more
- KPH Healthcare Services, Inc. (Ithaca, NY)
- …policies. **Job Su Summary:** Assist the professional staff in the triaging, processing and delivery of prescriptions to the patient. Assist in the management ... in the initial submission, and resubmission (as required) of all third party claims + Locating prescription files and other manual records from storage as needed… more
- City of New York (New York, NY)
- …significant and/or newsworthy requests. Assist in the supervision of clerical staff processing FOIL requests. - Under close direction may serve as liaison with ... work including reviewing litigation papers, compiling responses, and analyzing claims . - Conduct legal research and provide recommendations and interpretations… more
- Intermountain Health (Albany, NY)
- …of actual and budgeted contractual allowances and variances, monitoring of individual claims (logs), etc.). Interacts with HIM, PAS, and hospital finance staff as ... analysis. + Demonstrates computer skills including spreadsheets, databases, word processing , and Internet. + Demonstrated experience with third-party financial… more
- CenterWell (Liverpool, NY)
- …personnel communication systems, overall management of agency supplies / mail, and processing of accounts payables. Depending on branch census you may be responsible ... team at the branch to ensure other billing requirements are satisfied to release claims timely. . Adhere to and participate in Agency's mandatory HIPAA / Privacy… more