- Cardinal Health (Albany, NY)
- …+ Mails all paper claims . + Acts as a subject matter expert in claims processing . + Manages billing queue as assigned in the appropriate system. + Manages ... things done. **The Accounts Receivable Specialist II is responsible for processing insurance claims and billing. They will work within the scope of… more
- Molina Healthcare (Syracuse, 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
- Molina Healthcare (Rochester, 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
- Intermountain Health (Albany, NY)
- …+ **Essential Functions** + Oversees the day-to-day revenue cycle functions including claims processing , denials, payments, customer service, and follow up on ... + Insurance Processing and Issues + Medical Terminology + Claims Processing + Collaboration + Time Management + Team Building **Qualifications** + High… more
- Sedgwick (Albany, NY)
- …from an accredited college or university preferred. **Experience** 2-3 years experience processing work comp claims as an examiner. Familiar with CPT, ... to Work(R) Fortune Best Workplaces in Financial Services & Insurance Work Comp Claims Negotiator **PRIMARY PURPOSE** **:** To negotiate Out of Network bills that do… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …3 - 4 years' experience working with health plan-based prior authorization and claims processing systems. + Demonstrated ability and understanding to work ... Technician performs functions as permitted by law including the initial level processing and review of prior authorization requests for both pharmacy reviews and… more
- Rochester Regional Health (Rochester, NY)
- …actions. RESPONSIBILITIES: + Medical Billing Expertise: Proficient in billing, claims processing (Inpatient, Outpatient, Critical Access, Rural Health), ... terminology, physician fee schedules, DRGs, and reimbursement procedures. + Claims and Appeals Processing : Submits and follows up on insurance claims ;… more
- Molina Healthcare (Syracuse, NY)
- …and tests assumptions through data, but leads with contextual knowledge of claims processing , provider contracts, and operational realities. + Creates succinct ... operational initiatives tied to Payment Integrity (PI) and provider claims accuracy. The individual will be relied upon to...a business lens to ensure accurate interpretation of provider claims trends, payment integrity issues, and process gaps. +… more
- Mount Sinai Health System (New York, NY)
- …Accounts Receivable, Charge Entry, Edits and Payment Posting. This individual facilitates claims processing and payments services rendered by physicians and ... problem resolution to ensure accurate and timely payment of claims and collection. The Specialist works directly with the...+ 5 years experience in medical billing or health claims , with experience in IDX billing systems in a… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …Medicaid, CPT, HCPCS, ICD10, DRG, APC, RBRVS, etc.). + Extensive experience with claims processing systems, claims flow, adjudication process, system edits ... in a clear and concise manner. + Analyzes proactive detection reports and claims data to identify red flags/aberrant billing patterns. + Manages cases as assigned,… more