- FLACRA (Newark, NY)
- …Process claims, including handling clearinghouse rejections and resubmissions. + Resolve claim denials by working with insurance companies and internal teams. + Post ... charges and payments accurately in the billing system. + Monitor accounts receivable and follow up on outstanding balances. + Work with insurance companies to address disputed claims and resolve processing issues. + Maintain and update tracking spreadsheets… more
- SUNY Upstate Medical University (Syracuse, NY)
- …of insurance companies. Work with various departments and staff to resolve denials . Stays current on changes and updates from insurance industry. Provide support ... to front desk staff with questions and provide back-up when necessary; assist new staff member's integration into the team. Other clerical duties assigned as needed. Must be able to communicate effectively in order to transfer information, as well as complete… more
- Guthrie (Corning, NY)
- …determination of coverage of ordered medications. * *Coordinate and complete appeals for denials as needed * *Monitor and Review REMS clearance for monthly refills ... of high-risk medications ordered for patients Monitor and Manage Department in Basket * *E-Guthrie Medical Advice Requests * *Medication Cancellation notifications * *Electronic Refill Requests * *System generated Medication Authorization Request * *Staff… more
- Stony Brook University (Commack, NY)
- …+ Support internal operational departments by addressing contractual disputes, claim denials , and reimbursement issues. + Participate in and support Joint Operating ... Committee (JOC) meetings, contract settlement discussions, and reimbursement escalations. + Ensure compliance with Medicare and Medicaid reimbursement methodologies and stay current on commercial and government changes affecting the organization. + Monitor and… more
- Kelly Services (Rochester, NY)
- …via telephone, email, and mail regarding plan benefits, claim payments and denials , and eligibility in accordance with custom-designed benefit plans. This role ... requires a polite, professional, and courteous demeanor at all times while meeting the statistical goals of the position. **Essential Responsibilities:** + Researches and responds to inquiries via telephone, email, and mail from internal and external customers… more
- Catholic Health (Buffalo, NY)
- …reviewing billing information, verify accuracy of charges. Performs follow-up on insurance company denials on a timely basis + Review of all claims for accuracy + ... Review and identify errors or issues with billing and correct the issue for billing + Review and correct all response files from electronic submissions + Document all patient accounts with each action taken into appropriate system. + Follow up on all daily… more
- Arnot Health (Elmira, NY)
- …The Case Manager tracks and trends LOS, resource utilization, outliers, readmissions, denials , delay days and satisfaction of the case managed population. g. ... Consistently attends case management staff development meetings. h. Maintains a close working relationship with physicians managing the care of their caseload population. i. Is a resource person for the education of the case management team. j. Identifies… more
- Crouse Hospital (Syracuse, NY)
- …for denial management which includes researching, analyzing, resolving and trending denials specific to the revenue cycle. Requirements: + Bachelor's Degree in ... Business/Accounting/Finance or closely related field. + Minimum of three (3) to five (5) years' experience working in professional healthcare billing, reporting, and/or analysis. + Microsoft Access, Visio knowledge, experience with Medent software, preferred… more
- MTA (Jamaica, NY)
- …procedures and guidelines. + Provide recommendations and final approvals or denials of related project schedules, headcount requirements, flagging report, etc. + ... Direct the management of staff performance through interaction, review of management reports, and on-site inspections. + Provide status update summaries for projects and present monthly to all related and end users and project supporting departments. Present… more
- University of Rochester (Rochester, NY)
- …coding, resolving coding charge review and claim edits, and resolving coding denials . 25% Identifies and escalates coding issues and trends to management. Assists ... in recommending coding workflow solutions to resolve issues and improve operations. Facilitates staff training on new processes or identified quality issues. 25% The Coding Lead will retain coding assignments in their respective areas and will maintain… more