- Cognizant (Albany, NY)
- …and procedures. Provide support to claims and client issues related to claims adjudication and adjustments. Service Now and Inquiry resolution, and any basic ... duties as assigned by management. **Qualifications:** + A minimum of 2 years' claims processing experience is required. + Knowledge of physician practice and… more
- Cognizant (Albany, NY)
- …procedures. Provide support to claims and client for issues related to claims adjudication and adjustments, Service Now and Inquiry resolution, and any basic ... Processor** is responsible for the timely and accurate adjudication of professional and hospital claims utilizing...required + A minimum of 1 years of medical claims processing is required + Facets experience… more
- Highmark Health (Albany, NY)
- …**Required** + 1 year of related experience **Preferred** + 1 year of claims processing experience + Inquiry resolution system, OCWA, Oscar, Outlook experience ... correcting errors and/or performing quality control review and final adjudication of paper/electronic claims . Determines whether to...guidelines. + Knowledge of operating systems specific to claim processing . + Ability to review claims and… more
- Independent Health (Buffalo, NY)
- …certificate and/or college degree preferred. + Six (6) months of medical claims processing /medical billing experience, customer service experience preferably in ... relates to production, accuracy, knowledge of policy and procedure and timeliness of claims adjudication . + Analyze, identify and research, as needed, edits… more
- MVP Health Care (Rochester, NY)
- …3 years in health insurance or production-related environment. 2 years claims processing experience preferred. + Strong knowledge of Medicaid, Medicare, and ... At MVP Health Care, we're on a mission to create...**Your key responsibilities:** + Responsible for overseeing the end-to-end adjudication and processing of claims … more
- CVS Health (Albany, NY)
- …amount levels on customer service platforms, specifically by using technical and claims processing expertise. + Apply medical necessity guidelines, determine ... At CVS Health , we're building a world of health...and interpersonal skills. + Previous experience with DG system claims processing . **Education** + Associate's degree or… more
- Northwell Health (New York, NY)
- …conditions + Validates DRG grouping and (re)pricing outcomes presented by the claims processing vendor. Attends JOC meetings with providers as appropriate ... creating and testing compensation grids used for reimbursement and claims processing + Ensures that refund checks...within a healthcare or managed care setting (preferred) + Claims adjudication experience + Knowledge of MLTC/… more
- Sedgwick (Buffalo, NY)
- …**37.5 hour work week** **ESSENTIAL RESPONSIBILITIES MAY INCLUDE** + Analyzing and processing claims through well-developed action plans to an appropriate and ... behalf of our valued clients to determine benefits due, while ensuring ongoing adjudication of claims within service expectations, industry best practices, and… more
- Sedgwick (Albany, NY)
- …client service requirements. **ESSENTIAL RESPONSIBLITIES MAY INCLUDE** + Analyzing and processing claims through well-developed action plans to an appropriate ... behalf of our valued clients to determine benefits due, while ensuring ongoing adjudication of claims within service expectations, industry best practices, and… more
- Sedgwick (New York, NY)
- …growth, and inclusion. **ESSENTIAL RESPONSIBILITIES MAY INCLUDE** + Analyzing and processing claims through well-developed action plans to an appropriate ... behalf of our valued clients to determine benefits due, while ensuring ongoing adjudication of claims within service expectations, industry best practices, and… more