- Excellus BlueCross BlueShield (Rochester, NY)
- …Depending on the specific tasks assigned, the Medical Services Coordination Specialist provides administrative support for any of the programs of Utilization ... and related health plan functions such as member services, claims , and the referral process. As well as functions...appeals process within the + Medical Services department Level III (in addition to Level II Accountabilities) + Assists… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …to Level I qualifications) * One (1) year of experience in a Level I Claims Specialist role. * Adept at multi-tasking to efficiently resolve moderately complex ... by entering, sorting, distributing, or indexing items independently. Level III (in addition to Level II Accountabilities) * Performs...Two (2) years of experience in a Level II Claims Specialist role. * Ability to multi-task… more
- University of Rochester (Rochester, NY)
- …for non-routine letters of correspondence related to appeals on denied claims , including compiling all necessary information and drafts for provider signature. ... + Manages provider(s) documentation and information. + Composes and types of non-routine correspondence providing factual information. + Arranges travel, conference registration, and hotel accommodations. Interfaces with organizations, hospitals, and others to… more
- University of Rochester (Rochester, NY)
- …been collected through routine billing and collection activities. Claim Resolution Rep III will make independent decisions as to the processes necessary to collect ... denied insurance claims , no response accounts, and will investigate resolving billing...of billing Manager and Supervisor. The Claim Resolution Rep III will represent the department and Strong Memorial Hospital… more
- University of Rochester (Rochester, NY)
- …and internal equity considerations._ **Responsibilities:** GENERAL PURPOSE The Med Records Coder III functions as an advanced coder in the abstraction and in-depth ... guidelines. + Reviews and resolves coding denials. + Resolves problems with claims having errors related to improper coding and provides feedback for correction… more
- University of Rochester (Albany, NY)
- …and training, licensure, work history, hospital affiliation history, malpractice claims history, board certification status, criminal background, evaluation of ... Services Management (CPMSM) upon hire preferred + Certified Provider Credentialing Specialist (CPCS) upon hire preferred The University of Rochester is committed… more
- University of Rochester (Rochester, NY)
- …coding guidelines. + Reviews and resolves coding denials. Resolves problems with claims having errors related to improper coding and provides feedback for correction ... (RHIA) or (Registered Health Information Technician) RHIT or Certified Coding Specialist (CCS) preferred or + Certified Professional Coder (CPC) from American… more
- University of Rochester (Rochester, NY)
- …reviews to make corrections before transmittal. + Troubleshoots problems that prevent claims from being released. Identifies cause of edit and independently resolves ... (RHIA) or (Registered Health Information Technician) RHIT or Certified Coding Specialist (CCS) preferred + Certified Professional Coder (CPC) from American Academy… more
- Anthony Jordan Health Corp (Rochester, NY)
- RISK MANAGEMENT SPECIALIST ROCHESTER, NY (http://maps.google.com/maps?q=214C+Lake+Avenue+ROCHESTER+NY+USA+14608) * Corporate Compliance Apply Job Type Full-time ... ensure: . Risk identification and incident management . Proactive risk reduction and claims prevention . To manage and encourage ongoing education of Jordan Health… more
- City of New York (New York, NY)
- …Assistance Reimbursement Unit (ARU) is recruiting for one (1) Principal Administrative Associate III to function as an Operation Supervisor who will: - Directly and ... indirectly supervise ARU staff which consists of Clerical Associates, Eligibility Specialist , and Principal Administrative Associates involved in claim review and… more