- City of New York (New York, NY)
- …medical records requests from MCO to obtain prior authorization approvals and claim reimbursement. - Review all claims CPT/ICD-10/HCPCS, payment modifiers in ... perform health insurance billing activities and support functions including claim review, claim submission, follow up and...denials in a timely manner. - Prepare and batch claims out to third party payers for reimbursements. -… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …of the insurance contract. + Reviews and audits the Insured's benefit file and claim payment to encourage timely submission of claims . Responsible for ensuring ... Insured, Insured's family, care providers, and adjudication of the claims . All work is directed under the terms and...State time service standards. (this includes the task of claim payment) + Works closely with all providers and… more
- Leviton (Melville, NY)
- …looking for a Deduction Representative I to join the Credit, Accounts Receivable & Claims department. We need individuals who thrive on challenges and are eager to ... I is responsible for evaluating, processing, and resolving customer claims (deductions), working together with customers and various internal departments.… more
- Sedgwick (Albany, NY)
- …General Adjuster - Northeast Region **PRIMARY PURPOSE** **:** To handle losses or claims regionally unassisted up to $10M, including having the ability to address ... and non-complex National Accounts. **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Examines claim forms and other records to determine insurance coverage. +… more
- CDPHP (Latham, NY)
- …the timely and accurate facilitation and handling of all incoming paper claim and correspondence documents. All tasks are performed on-site. This includes performing ... a detailed mail sort, batch preparation, and scanning of all incoming claims and correspondence to facilitate and ensure compliance with all New York State… more
- University of Rochester (Brighton, NY)
- …May research information to assist legal counsel + Produces reports, audits claim , evaluates eligibility and entitlements and considers multiple leave options to ... payments. + Exercises discretion and independent judgement when identifying claim discrepancies and recommends resolution processes. Directs vendors related to… more
- Allied Universal (Bronx, NY)
- Advance Your Career in Insurance Claims with Allied Universal(R) Compliance and Investigation Services. Allied Universal(R) Compliance and Investigation Services is ... the premier destination for a career in insurance claim investigation. As a global leader, we provide dynamic opportunities for claim investigators, SIU… more
- Ellis Medicine (Schenectady, NY)
- …Review and resolve outstanding accounts receivable with insurance companies and patients. + Claims in dispute with payers are reviewed daily to ensure the provider ... and payers are in agreement for appropriate claims reimbursed. + Monthly meetings with all payers to...correction if there is a registration error or missing claim form. + Once all errors have been identified… more
- General Dynamics Information Technology (Menands, NY)
- …Required:** None **Job Family:** Professional Engineering **Skills:** Healthcare Claims ,Quality Assurance (QA),Structured Query Language (SQL) **Experience:** 2 + ... to the Quality Assurance Regression (QAR) baseline + Add claim 837 (I, D and P) test cases to...TECHNICAL SKILLS: + 837 (I, P and D) Medical Claims testing experience + Knowledge of X12 + Experience… more
- Leviton (Melville, NY)
- …recording and application of all customer cash receipts and the posting of claims and chargebacks. This role will evaluate, process, and resolve customer deductions ... generating resolution effort reports in Excel to highlight trends and track claim outcomes. Collaborate with outside sales, logistics, warehouse, and customers to… more