- Healthfirst (NY)
- …degree from an accredited institution + Experience in Healthcare/Health Plan customer service , operations, vendor management, or claims processing. + Previous ... for proper function, quality, and in support of enhancing Member/Provider service experiences. + Experience applying critical thinking skills and problem-solving… more
- Brighton Health Plan Solutions, LLC (New York, NY)
- …benefits, eligibility, claims inquiry, claim reconsiderations and appeals. The Customer Service Representatives must be able to work in various shifts Monday to ... About The Role The Customer Service Representative, Bilingual, assists members, physicians, hospitals, revenue...calls from members, medical providers, and others. + Adjust claims accurately, if needed. + Listen to and address… more
- MetLife (Oriskany, NY)
- …of explanation based on policy provisions and claim documents. Provides customer service with empathy and patience on incoming and outgoing phone inquiries and ... and obtain missing information required to evaluate FEGLI life claims and input information into a Power Builder computer...customers by taking ownership and projecting an attitude of service . . Maintain production and quality standards. . Keep… more
- New York State Civil Service (Oxford, NY)
- …NY Zip Code 13830 Duties Description Will perform medical billing and claims processing, including payment, coordination or subrogation of benefits. Review claims ... and benefit plan interpretation to patients or their representatives. Review claims for irregularities, accuracy, completeness, and obtains additional information as… more
- Axis (New York, NY)
- …lines insurance and reinsurance. We stand apart for our outstanding client service , intelligent risk taking and superior risk adjusted returns for our shareholders. ... selection process. **Job Description** AXIS is seeking a **_Senior Claims Specialist - Environmental Claims_** to join our North...as well as the broader portfolio impact and customer service impact of coverage disputes and issues + Excellent… more
- Travelers Insurance Company (Melville, NY)
- …evaluating, reserving, negotiating and resolving assigned serious and complex Specialty claims . Provides quality claim handling throughout the claim life cycle ... **What Will You Do?** + Directly handle assigned severe claims . + Full damage value for average claim (without...over a multi-million dollar value. + Provide quality customer service and ensure file quality, timely coverage analysis and… more
- New York State Civil Service (Albany, NY)
- …Manager, Cost Control takes a lead role in Project Controls functions of claims management, claims negotiation, and litigation support on complex capital ... schedule, number of contracts, management approach, delivery method, level of service , phasing, customer orientation, staffing, labor, location and site access,… more
- University of Rochester (Rochester, NY)
- …responsible for the accurate and timely preparation and submission of third-party billing/ claims to governmental or third-party payers. Re-submits claims that ... fail third party edits and submits second level claims . Provides guidance and support to Billing Assistant and...training such as Strong Commitment, ICare and Annual In- Service + Join PAO committees such as planning PAO… more
- University of Rochester (Rochester, NY)
- …independent decisions as to the processes necessary to collect denied insurance claims and resolve billing issues. Must track payer/billing issues that affect ... reimbursement of claims and advising the management team of those trends...such as Strong Commitment ICARE and Annual Mandatory in Service Qualifications Associates degree in Business Administration and 4-5… more
- City of New York (New York, NY)
- …City of New York employees serving in a permanent (not provisional) civil service title of Claim Specialist. Please clearly state your permanent civil service ... Law & Adjustment is responsible for investigating and adjusting claims filed for and against the City of New...New York serving in a permanent (not provisional) civil service title of Claim Specialist. Please clearly state your… more