- Brighton Health Plan Solutions, LLC (Westbury, NY)
- …employers and claimants in regard to claimants' workers' compensation cases. Provide claims processing for the Workers' Compensation and No-Fault lines of ... About The Role MagnaCare provides Utilization Review/ Case Management/ Medical Management/ Claims Review services to its clients. Care Coordinators facilitate care… more
- Sedgwick (Albany, NY)
- …Coordinator **PRIMARY PURPOSE** : To analyze low- and mid-level workers compensation claims to determine benefits due; and to ensure ongoing adjudication of ... claims within company standards and industry best practices. **ESSENTIAL...files necessary documentation with state agency. + Communicates claim action/ processing with appropriate parties including, but not limited to… more
- WMCHealth (Valhalla, NY)
- …Features of the Class: Under general supervision, an Insurance Clerk processes insurance claims to third party health carriers for billing of medical services ... and in the general type of information required by health and hospital insurance carriers; familiarity with medical terms;...of clerical experience, one year of which included the processing of patients' medical insurance claims as… more
- Humana (Albany, NY)
- …2 opening available. The Payment Integrity Professional 2 utilizes vendor platforms, claims processing platforms, and data to collaborate with key internal ... part of our caring community and help us put health first** The Code Edit Management Organization has a...and external business stakeholders, while supporting claims code editing pre and post-implementation and functionality. The… more
- Independent Health (Buffalo, NY)
- …daily basis. Assist in interpreting database information as it relates to pharmacy claims processing . + Assist with PBM implementation by identifying potential ... department with various data entry projects/information as they relate to pharmacy claims processing . C. Administrative Duties + Provide accurate and up-to-date… more
- MVP Health Care (Rochester, NY)
- At MVP Health Care, we're on a mission to create a healthier future for everyone - which requires innovative thinking and continuous improvement. To achieve this, ... and comprehensive benefits focused on well-being + An opportunity to shape the future of health care by joining a team recognized as a **Best Place to Work For in… more
- Rochester Regional Health (Rochester, NY)
- …effectively and accurately managing a receivable. Resolve edits to ensure accurate claims are sent to primary and secondary insurances. Research and resolve denials ... payer website, coverage policies and/or phone calls to the payer. Submit corrected claims and appeals. + Process account adjustments and refunds as needed according… more
- Northwell Health (Lake Success, NY)
- …patient accounts for hospital and clinical facilities. Daily duties include processing claims , addressing patient billing inquiries, collecting payments, ... problems, attending to inquiries regarding an account. Job Responsibility + Assists in processing and managing patient claims . + Assists in collecting payments… more
- CDPHP (Latham, NY)
- …in 1984, CDPHP is a physician-founded, member-focused, and community-based not-for-profit health plan that offers high-quality affordable health insurance to ... the completion of the necessary activities related to the processing of incoming mail for the entire organization, as...mail sort, batch preparation, and scanning of all incoming claims and correspondence to facilitate and ensure compliance with… more
- Mount Sinai Health System (New York, NY)
- …and analytic development skills and impact the patient community of the Mount Sinai Health System. **Qualifications** + BA or BS degree minimum, in a relevant field ... 5 years minimum in analytics development expertise, preferably in health care, or for a health provider,...care EMR such as Epic/Clarity, eCW, etc.; a payor claims system such as Facets, Amisys, etc.; or a… more