- Mount Sinai Health System (New York, NY)
- **Job Description** The Billing Specialist is responsible for multiple components of the billing & coding process, including Accounts Receivable, Charge Entry, Edits ... these processes to ensure accurate and timely payment of claims and collection, and in analysis and problem resolution....specialty coding for services and medical office visits and review physician coding and provide updated to physicians and… more
- Molina Healthcare (Buffalo, NY)
- …* Applies contract language, benefits and review of covered services to claims review process. * Contacts providers as needed via written and verbal ... JOB DESCRIPTION Provides support for claims activities including reviewing and resolving **Provider No...internal and/or regulatory timelines are measured correctly. * Researches claims using support systems to determine **Provider No Surprise… more
- Constructive Partnerships Unlimited (Manhattan, NY)
- …Apply Now (https://phe.tbe.taleo.net/phe03/ats/careers/v2/applyRequisition?org=CPOFNYS&cws=37&rid=6269) Job Brief The QA/QI Review Specialist is responsible for ... expanded our constituency to include supportive housing. POSITION SUMMARY The QA/QI Review Specialist is responsible for completing internal quality reviews… more
- Family and Children's Association (Mineola, NY)
- Contract Specialist Location: Garden City, NY | Schedule: Full time 35/hours | Status: Non-Exempt |Salary: $23-29/Hour The Opportunity The Contract Specialist is ... responsible for timely preparation, submission and payment reconciliation for claims submitted to various funding sources (local, state and federal government,… more
- Constructive Partnerships Unlimited (Manhattan, NY)
- Incident Management Investigator Specialist II Type of Position Full time Search Location(s) Manhattan, NY Apply Now ... (https://phe.tbe.taleo.net/phe03/ats/careers/v2/applyRequisition?org=CPOFNYS&cws=37&rid=7104) Job Brief The Incident Management Investigator Specialist II (IMIS-II) works closely with the Incident Management… more
- Sedgwick (Albany, NY)
- …Fortune Best Workplaces in Financial Services & Insurance (Remote) EDI Support Specialist - Casualty **PRIMARY PURPOSE** **:** To identify, research, resolve, and ... Representatives on a variety of complex issues including expert review of International Association of Industrial Accident Boards and...to include two (2) years of workers' compensation or claims related experience and three (3) years of EDI… more
- Colgate-Palmolive (New York, NY)
- …let's build a brighter, healthier future for all. The Leave Administration Specialist (Contract) reports to the Leave Administration Manager and supports the Manager ... address deviations with stakeholders. Day-to-Day Responsibilities: + Case management: Review leave requests (FMLA, STD/LTD, parental, medical, military, ADA); verify… more
- WMCHealth (Poughkeepsie, NY)
- …a potential lawsuit, etc.) and alerts the department director, administration, and the claims manager. Initiates a more thorough review to clarify the ... Quality Improvement Specialist - RN Company: MidHudson Regional Hospital City/State: Poughkeepsie,...PI + Screens cases to identify issues for physician review , using criteria established by the medical staff and… more
- CVS Health (Albany, NY)
- …Efficiently use multiple systems and screens to obtain and record claim information - Review claims information to determine the nature of a member's illness or ... each and every day. **Job Summary** Reviews and adjudicates claims in accordance with claim processing guidelines. Claim Benefit...by providing accurate and timely resolution in processing medical claims . You will be a key link in providing… more
- Molina Healthcare (Syracuse, NY)
- …to ensure that internal and/or regulatory timelines are met. + Research claims appeals and grievances using support systems to determine appeal and grievance ... standards set by the department. + Apply contract language, benefits, and review of covered services + Responsible for contacting the member/provider through written… more