- Excellus BlueCross BlueShield (Rochester, NY)
- …. Ensures accurate payment by independently utilizing DRG grouper, encoder, and claims processing platform. . Manages case volumes and review/audit schedules, ... business analysis. . Intermediate knowledge of PC, software, auditing tools and claims processing systems. Level II (in addition to Level I Qualifications) .… more
- Molina Healthcare (Yonkers, NY)
- …concisely, accurately and in accordance with regulatory requirements. * Researches claims processing guidelines, provider contracts, fee schedules and systems ... or equivalent combination of relevant education and experience. * Health claims processing experience, including coordination of benefits (COB), subrogation… more
- Mount Sinai Health System (New York, NY)
- …processes, and related regulations. ? Familiarity with contract terms, NYS regulations, claims processing , and healthcare reimbursement models. ? Experience in ... contract language to ensure proper interpretation and application of terms during claims processing . * Ensure that all contract terms are being adhered to in… more
- Access: Supports For Living (Middletown, NY)
- …identified revenue cycle billing issues + Handling billing cycle review procedures for pre- processing (scrubbing) of weekly claims processing + Analyze, ... throughout the revenue cycle. This individual manages the electronic claims process, including accurate and timely claim batch creation,...billing and processing program claims for accuracy and completeness; submit claims … more
- Molina Healthcare (Buffalo, NY)
- …concisely and accurately in accordance with regulatory requirements. * Researches claims processing guidelines, provider contracts, fee schedules and systems ... or equivalent combination of relevant education and experience. * Health claims processing experience, including coordination of benefits (COB), subrogation… more
- Sedgwick (Albany, NY)
- …total loss evaluations, and related expenses to effectively negotiate first and third party claims . + Knowledge of total loss processing , State salvage forms and ... a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Representative | Auto | Remote Are you looking for an opportunity to join… more
- Sedgwick (Syracuse, NY)
- …regulations and processes. This position is responsible for managing and processing workers' compensation claims , ensuring timely and accurate decisions ... Work(R) Fortune Best Workplaces in Financial Services & Insurance Workers Compensation Claims Examiner | NY Jurisdiction | NY Licensing Preferred Job Description… more
- Molina Healthcare (Albany, NY)
- …concisely and accurately, in accordance with regulatory requirements. + Research claims processing guidelines, provider contracts, fee schedules and system ... years operational managed care experience (call center, appeals or claims environment). + Health claims processing...center, appeals or claims environment). + Health claims processing background, including coordination of benefits,… more
- City of New York (New York, NY)
- …Area Supervisor, who will: - Directly and indirectly supervise staff in Claims processing /establishment of claims /recovery of manual payments/Program ... support. Track and ensure productivity of processing case actions in claims , establishment and imaging or recovery units. - Develop, complete, review and… more
- Mount Sinai Health System (New York, NY)
- …required. Familiarity with CPT and ICD (coding and CCI edits) + Electronic claims processing preferred. **Responsibilities** 1. Follows up on submitted claims ... secondary balances to appropriate financial class and provides documentation for processing the claims . 6. Reviews Credit Letter Sent (CLS) and transfers balance… more