- Mount Sinai Health System (Elmhurst, NY)
- **Job Description** Review Medical charts and documentation within but not limited to the facility EMR, Epic, to ensure that all Physician charges are captured in a ... protocols and third party requirements regarding coding and billing documentation. Review and code patient encounters in EPIC with appropriate CPT, ICD-9CM,… more
- KPH Healthcare Services, Inc. (Gouverneur, NY)
- …monthly, quarterly, and annual management reports for PBM clients, and from our Claims Processor. + Assist with on-site client orientation, health fairs and business ... call center team members, in coordination with the call center leadership. + Review training materials and processes for all call center departments to ensure… more
- University of Rochester (Rochester, NY)
- …Documents all account follow up activity. + Research and calculate under or overpaid claims ; determine final resolution + Review and determine correct follow up. ... as to the processes necessary to collect denied insurance claims , no response accounts, and will investigate resolving billing...+ Works in assigned EPIC follow up workqueue(s). + Review reason for claim denial - reason code or… more
- Independent Health (Buffalo, NY)
- …and assist with process improvements. Participate in any ad-hoc projects as needed. + Claims Management and Payment: Responsible for daily review of the payment ... allow Pharmacy Benefit Dimensions (PBD) to accurately adjudicate prescription claims against the pharmacy benefits of its members and...pertains to all lines of business. Attend assigned MOD review meetings, test and/or review SR's assigned… more
- Cardinal Health (Albany, NY)
- …- 3:30 PM PST (or based on business need)** **_What Accounts Receivable Specialist contributes to Cardinal Health_** Account Receivable Specialist is responsible ... for verifying patient insurance and benefits, preparing and submitting claims to payers, correcting rejected claims , following...other status protected by federal, state or local law._ _To read and review this privacy notice click_ here… more
- Cardinal Health (Albany, NY)
- …skills and prioritizes getting the right things done. **The Accounts Receivable Specialist II is responsible for processing insurance claims and billing. ... from AR & Billing leadership teams.** **_Responsibilities_** + Processes claims : investigates insurance claims ; and properly resolves...other status protected by federal, state or local law._ _To read and review this privacy notice click_ here… more
- Oak Orchard Health (Brockport, NY)
- …the third-party billing organization to ensure proper processing of all payer claims . This would include research for accuracy, analyze reports, follow through ... the third-party billing company + Manage Accounts Receivable related to all claims and ensure reconciliation with the general ledger. This involves working closely… more
- City of New York (New York, NY)
- …requests from MCO to obtain prior authorization approvals and claim reimbursement. - Review all claims CPT/ICD-10/HCPCS, payment modifiers in billing software to ... Billing by working alongside a team of talented health insurance billing specialist , you will perform health insurance billing activities and support functions… more
- Molina Healthcare (NY)
- …post pay claims with corresponding medical records to determine accuracy of claims payments. + Review of applicable policies, CPT guidelines, and provider ... and medical records to document relevant findings of a post pay clinical review . This position manages documents and prioritizes case load to ensure timely turn… more
- Rochester Regional Health (Rochester, NY)
- … Review : Conduct detailed reviews of denied or underpaid claims , prepare appeal letters, gather supporting documentation, and collaborate across departments ... Hours: 37.5 SCHEDULE: Monday-Friday 8AM-4PM SUMMARY: A Medical Billing and Denials Specialist is responsible for managing the billing process, submitting claims … more