- MTA (New York, NY)
- …claims management industry products. This role requires a robust understanding of claims processing and insurance risk management solutions, along with a ... experienced systems engineer with a minimum of eight years' experience in claims , insurance or risk management cloud applications, preferably with the Origami Risk… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …management. + Customer Operations Operational Improvement Specific: + Supports Workforce Planning, Processing Accuracy, Claims Processing and Customer Care ... in the development and implementation of quality plans for the accurate processing of claims pends, adjustments and Customer Care inquiries across all areas in… more
- Cardinal Health (Albany, NY)
- …as required, necessary, or appropriate. + Acts as a subject matter expert in claims processing . + Processes claims : investigates insurance claims ; ... administration customer and vendor pricing, rebates, billing (including drop-ships), processing chargebacks and vendor invoices and developing and negotiating… more
- Excelsior Orthopaedics Group (Amherst, NY)
- …with clinical staff, management, and external vendors to ensure smooth billing and claims processing . + Prepare and maintain detailed reports of billing ... for the surgery center. This includes ensuring accurate and timely submission of claims to insurance companies, processing patient billing, and following up on… more
- MVP Health Care (Rochester, NY)
- …field preferred. + The availability to work [full-time, virtual] + Medical claims processing experience required. Familiarity with CPT-4 and ICD-10 procedural ... and Recovery Associate to join #TeamMVP. If you have a passion for claims investigation, payment accuracy, and collaborative problem solving, this is the opportunity… more
- Mount Sinai Health System (New York, NY)
- …are properly understood, interpreted, and applied across the organization, especially within claims processing . 3. Escalation and Issue Resolution: * Identify, ... law, and the revenue cycle, with particular focus on PB and HB claims . o Understanding of the legal and regulatory environment surrounding healthcare contract… more
- WTW (New York, NY)
- …level claim regulatory requirements and compliance.** + **Significant experience with claims processing systems.** + **Significant experience in managing TPA's ... stewardship client meetings, assist underwriting in their renewal process, audit claims performance against best practices, and implement value added services.** +… more
- Molina Healthcare (Rochester, NY)
- …have strong experience with Benefits and contracts configuration in QNXT + Must have claims processing experience + Knowledge is SQL + Experience is Excel is ... accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims databases. Synchronizes… more
- CDPHP (Albany, NY)
- …and rules, including benefits, pricing, enrollment, billing, provider structure, payment and/or claims processing for each line of business. + Must have ... team's delivery of the analysis, maintenance, and configuration of CDPHP's core claims systems and applications application systems, as well as modifying existing… more
- Molina Healthcare (NY)
- …Ensure that provider information is loaded accurately to allow for proper claims processing , outbound reporting and directory processes. **JOB QUALIFICATIONS** ... for accurate and timely maintenance of critical provider information on all claims and provider databases. Maintains critical provider information on all claims… more