- KPH Healthcare Services, Inc. (East Syracuse, NY)
- …monthly, quarterly, and annual management reports for PBM clients, and from our Claims Processor + Assist with on-site resolution of customer service issues to ... clients + Training, coaching and development of call center staff + Assist with determining staffing/scheduling needs for ProAct Call Center + Providing call resolution in elevated customer service issues + Daily coaching and audits + Create and update… more
- Stony Brook University (East Setauket, NY)
- …support day-to-day business functions including but not limited to: billing, claims analysis appeals, follow-up, financial assistance and customer service. **Duties ... are not limited to:** + Prepare and submit hospital claims . Review denials. Investigate coding issue. Audits. + Follow-up...minimum of 6 months business experience, preferably in a healthcare setting; **_or_** an Associate's degree and at least… 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 and ... external business stakeholders, while supporting claims code editing pre and post-implementation and functionality. The...benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …policies and procedures and related health plan functions such as member services, claims , and the referral process. As well as functions related to legislative and ... case for clinical staff. + Navigates and utilizes corporate applications; core claims and membership system, intranet and related links to provide support to… more
- Stony Brook University (East Setauket, NY)
- …support day-to-day business functions including but not limited to: billing, claims analysis appeals, follow-up, financial assistance and customer service. **Duties ... are not limited to:** + Prepare and submit hospital claims . Review denials. Investigate coding issue. Audits. + Follow-up...minimum of 6 months business experience, preferably in a healthcare setting; or in lieu of a Bachelor's degree,… more
- CDPHP (Latham, NY)
- …performing a detailed mail sort, batch preparation, and scanning of all incoming claims and correspondence to facilitate and ensure compliance with all New York ... service levels. Ownership is assumed for all aspects of claims examining and data entry on the FormWorks system,...Six (6) months alphanumeric data entry experience in a healthcare setting is required. + High school diploma or… more
- The Institute for Family Health (New Paltz, NY)
- …companies, medical professionals and patients' on daily basis to resolve claims processing issues. + Recognize issues relating to provider credentialing and ... responsible for Claim Printing/Reviewing of printed claim forms for accuracy to ensure claims are paid timely. + May be responsible for the submission of electronic… more
- Robert Half Accountemps (Syracuse, NY)
- …billing processes for Home Health Care services, ensuring accuracy in claims submission and payment processing. Candidates should possess a strong background ... in accounts receivable management and electronic claims systems, coupled with exceptional analytical and problem-solving skills. Responsibilities: * Review and… more
- Brighton Health Plan Solutions, LLC (Melville, NY)
- …Customer Service Representatives to assist members, physicians, hospitals, and other healthcare providers with member benefits, eligibility, claims inquiry, ... required. About At MagnaCare, our goal is simple: uncomplicate the administration of healthcare benefits. For more than 30 years, we've done just that, serving… more
- Independent Health (Buffalo, NY)
- …phone calls. The COB Coordinator will also be responsible for basic claims adjudication, performing basic claim adjustments and working defined reports. The COB ... maintain an acceptable level of production as outlined in the Claims /COB Performance Management Policy with minimal supervision and demonstrate basic problem-solving… more