- Sedgwick (Albany, NY)
- …client service requirements. **ESSENTIAL RESPONSIBLITIES MAY INCLUDE** + Analyzing and processing claims through well-developed action plans to an appropriate ... Fortune Best Workplaces in Financial Services & Insurance (Remote) Claims Examiner - Workers Compensation | AZ, CO, UT... within designated authority. + Communicating claim activity and processing with the claimant and the client. + Reporting… more
- Sedgwick (Syracuse, NY)
- …and specific client service requirements. **ESSENTIAL RESPONSIBILITIES** + Analyzing and processing claims through well-developed action plans to an appropriate ... Work(R) Fortune Best Workplaces in Financial Services & Insurance Workers Compensation Claims Examiner | NY Jurisdictional Knowledge & NY Licensing Required Are you… more
- 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 (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
- Humana (Albany, NY)
- …outcomes. **Key Responsibilities:** + Lead large-scale product efforts focused on improving claims processing and related systems, ensuring these efforts support ... with special attention to privacy, security, and regulatory requirements in claims processing . + Act as an escalation point for critical delivery blockers… 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
- Molina Healthcare (Yonkers, NY)
- …payment methodology & processing is essential + Understanding on hospital claims processing and configuration works + Medicare fee schedule knowledge is ... experience **Required Experience** 5-7 years in SQL, Medicare, Networx, QNXT, claims processing and hospital claims payment method. **Preferred Education**… more
- Robert Half Accountemps (Forest Hills, NY)
- …role, you will manage various billing functions, ensuring accuracy and efficiency in processing claims , invoices, and payments. This is a long-term contract ... * Prepare and process billing statements and invoices with precision. * Handle claims processing for Medicaid and healthcare-related billing. * Investigate and… more
- Molina Healthcare (Syracuse, NY)
- …Networx. + Experience with QNXT is preferred. + Advanced experience using a claims processing system. + Advanced experienced verifying documentation related to ... updates/changes within a claims processing system. + Advanced experience validating and confirming information related to provider contracting, network… more
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