- University of Rochester (Rochester, NY)
- …conforms to federal and state regulations bringing concerns to the attention of billing Manager and Supervisor. The Claim Resolution Rep III will represent the ... not been collected through routine billing and collection activities. Claim Resolution Rep III will make independent decisions as...insurance refund credits. + Review and advise supervisor or manager of trends on incorrectly paid claims … more
- University of Rochester (Rochester, NY)
- …to insurance companies to determine reason for claim denial or reason for unpaid claim . Address unpaid claims , and solicit a payment date from the payer. - - ... - Research and calculate underpaid or overpaid claims ; determine final resolution.- - - Re-calculate ...of credits - - Review and advise supervisor or manager on trends of incorrectly paid claims … more
- University of Rochester (Rochester, NY)
- …to insurance companies to determine reason for claim denial or reason for unpaid claim . Address unpaid claims , and solicit a payment date from the payer. + ... Research and calculate underpaid or overpaid claims ; determine final resolution.- - - Re-calculate ...refund of credits + Review and advise supervisor or manager on trends of incorrectly paid claims … more
- Kelly Services (New York, NY)
- **Account Manager - Medical Benefits** **Location: Brooklyn, NY or Manhattan, NY - Hybrid** **Salary: $70,000-85,000** **Direct Hire Opportunity!** **Kelly** has an ... amazing opportunity for an experienced and successful **Account Manager ** to join a leading **3rd party Health Benefits Administrator** based out of their… more
- CDM Smith (Albany, NY)
- …Assist the project team in developing and maintaining a project risk register. Claim management: Early support for claims and disputes on the project. ... to those requirements. Ensure that proper documentation is developed and maintained for claims . **Job Title:** Commercial Manager - Pacific **Group:** CCI ESS… more
- University of Rochester (Albany, NY)
- …pertain to claim processing and coding. Escalates system issues preventing claims submission and follow-up for review and resolution. + 5% Collaborates with ... individual, and internal equity considerations._ **Responsibilities:** GENERAL PURPOSE The Claims Resolution Representative III is responsible for working across the… more
- Guardian Life (New York, NY)
- Guardian is seeking a DHMO Product Manager who will play a key role in the strategic development and management of Guardian's DHMO Products for the employer market. ... partnership with provider contracting, legal, compliance, underwriting, network, and claims . Additionally, this individual will help identify, prioritize, and design… more
- Sedgwick (Albany, NY)
- …Work(R) Fortune Best Workplaces in Financial Services & Insurance Telephonic Case Manager **PRIMARY PURPOSE OF THE ROLE:** While partnering with the injured worker, ... support systems. + Effectively communicates and builds relationships with the claims ' examiner, client, injured worker, attorney and supervisor. + Identifies issues… more
- Latham, The Pool Company (Latham, NY)
- … communicates with homeowners and dealers regarding warranty/ non warranty items ( claims , repairs, inquiries, etc.). This manager will handle escalations from ... warranty admin staff, sales, and other internal stakeholders. The manager will be responsible for daily reporting, employee development, and other projects as… more
- CVS Health (Albany, NY)
- …in support of an international network, medical cost management and overall claim /customer service strategies. This role will provide concierge level of service to ... float management. + Ensuring service level adherence (GOP TAT, eligibility processing, claim TAT, reconciliation TAT, fee invoicing etc) + Ensure TPA networks are… more