- Molina Healthcare (Rochester, NY)
- …Provider Network Operations, Hospital or Physician Billing, or similar. + Claims processing background including coordination of benefits, subrogation, and/or ... and timely validation and maintenance of critical provider information on all claims and provider databases. Staff ensure adherence to business and system… more
- City of New York (New York, NY)
- …individual lines, and reduce budgets. The DFRP is recruiting for (3) three Eligibility Specialist level III to function as Group Processing Workers, who will: - ... Job Description APPLICANTS MUST BE PERMANENT IN THE ELIGIBILITY SPECIALIST CIVIL SERVICE TITLE OR IF YOU ARE HIRED...and contractual standards. The Division of Financial Review and Processing (DFRP) is responsible for the initiation of adverse… more
- Healthfirst (NY)
- …+ Experience in clinical practice with experience in appeals & grievances, claims processing , utilization review or utilization management/case management. + ... Reduction, Termination, and Suspension of services. The end-to-end process requires the Specialist to independently: + Research issues + Quality of Care Experience +… more
- ConnextCare (Pulaski, NY)
- …NY (http://maps.google.com/maps?q=61+Delano+St.+Pulaski+NY+USA+13142) Description Basic Function: The Benefits Specialist position is responsible for directing and ... all Employee Incident Reports, maintain OHSA reporting logs 18. Oversee Worker's Compensation claims 19. Assign and track completion of all annual inservices for the… more
- Rochester Regional Health (Rochester, NY)
- Job Title: Clinical Risk Management Specialist Department: Clinical Risk ManagementLocation: Riedman CampusHours Per Week: 40Schedule: Monday - Friday, 8am - ... 4:30pmSUMMARY The Clinical Risk Management Specialist plays a pivotal role in enhancing patient safety and improving the quality of care within the organization… more
- Robert Half Accountemps (Rochester, NY)
- …update records. * Assist with claim administration, including resolving billing discrepancies and processing claims . * Respond to inbound calls from clients to ... Description We are looking for a dedicated Collections Specialist to join our team on a long-term contract basis in Rochester, New York. In this role, you will focus… more
- CVS Health (Amherst, NY)
- …stop loss carrier. **Required Qualifications** *Minimum of 1 year of experience in healthcare claims processing *Minimum of 2 years of experience with the suite ... challenging role provides exposure to virtually all aspects of healthcare claims administration, from reinsurance/stop loss, data analytics, provider and broker… more
- Arnot Health (Elmira, NY)
- …assists employees with interpretation and application of Arnot Health benefits (ie claims processing , waiting period, qualifying events, covered expenses) and ... from the employee.* 11. Responsible for the filing of life insurance claims and assisting employees and/or beneficiaries. 12. Communicates with employees, managers,… more
- TEKsystems (Rochester, NY)
- …authorization for medical information/PHI to evaluate for HIPAA compliance prior to processing . - Receives and processes requests for patient health information in ... are prepared for certification - Works with ROI vendor in tracking and processing releases assigned to the vendor and with other RRH stakeholders. - Participates… more
- Racker (Ithaca, NY)
- …Generates reports to track utilization data and trends. + Processes Workers' Comp claims and follow up for injured employees. Tracks trends and generates reports for ... with new-hire orientations - to include providing benefits information and processing clearances. + Performs quality checks of benefits-related data, including PPACA… more