- CVS Health (Albany, NY)
- …every day. **Position Summary** Reviews and adjudicates complex, sensitive, and/or specialized claims in accordance with plan processing guidelines. Acts as a ... At CVS Health , we're building a world of health...problems. **Additional Responsibilities:** Reviews pre-specified claims or claims that exceed specialist adjudication authority or processing… more
- Molina Healthcare (Syracuse, NY)
- …Bachelor's Degree or equivalent experience Prior experience in Payment Integrity and/or COB/ Claims roles at a health plan or vendor. Familiarity with ... Lead Analyst, Configuration Oversight to support our Payment Integrity and Claims Operations teams in ensuring the accuracy and compliance of Coordination… more
- Access: Supports For Living (Middletown, NY)
- …identified revenue cycle billing issues + Handling billing cycle review procedures for pre- processing (scrubbing) of weekly claims processing + Analyze, ... billing and processing program claims for accuracy and completeness; submit claims ...weekly billing batches (uploads and response files) in Electronic Health Record (MyEvolv) + Understand clients' insurance benefits utilizing… more
- University of Rochester (Rochester, NY)
- …as to why claims are not paid and steps necessary for processing /payment. + Initiate collection phone calls to insurance companies to determine reason for claim ... independent decisions as to the processes necessary to collect denied insurance claims and resolve billing issues. Must track payer/billing issues that affect… more
- University of Rochester (Rochester, NY)
- …as to why claims are not paid and steps necessary for processing /payment. - - Initiate collection phone calls to insurance companies to determine reason for ... independent decisions as to the processes necessary to collect denied insurance claims and resolve billing issues. Must track payer/billing issues that affect… more
- University of Rochester (Albany, NY)
- …through telephone calls, payer website, and written communication to ensure accurate processing of claims . Collaborate with appropriate departments to generate a ... rejection or denial codes as they pertain to claim processing and coding. Escalates system issues preventing claims...you're looking for a career in higher education or health care, the University of Rochester may offer the… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …members' specific contract benefits, consistent with products, policies and procedures and related health plan functions such as member services, claims , and the ... for employee development and promotional opportunities. All Levels + LPN, Medical Assistant, Health Plan customer service or claims processor experience with a… more
- Human Technologies Corporation (Utica, NY)
- Job Description The Environmental Health and Safety Manager supports Human Technologies' mission of Creating Employment for People with Disabilities by ensuring ... * Perform the duties of our Site Safety and Health Officer and create and maintain Accident Prevention Plans...assess, document, and track incidents, near misses, and potential claims that may present a risk of loss to… more
- Highmark Health (Albany, NY)
- **Company :** Highmark Health **Job Description :** **JOB SUMMARY** Are you an architect of interconnected data, driven by the belief that relationships hold the key ... network of patient journeys, disease progressions, and treatment efficacy? Highmark Health is seeking a groundbreaking Lead Data Scientist, Research & Development,… more
- Elevance Health (Latham, NY)
- …**Preferred Skills, Capabilities, and Experiences:** + 1-3 years experience in claims processing , provider, or credentialing strongly preferred. For candidates ... Network Data Specialist IA proud member of the Elevance Health family of companies, Carelon Behavioral Health ,...for accurate and timely maintenance of provider information on claims and provider databases. **How You Will Make an… more