- University of Rochester (Albany, NY)
- …of claims. Collaborate with appropriate departments to generate a detailed rational for appeals and grievances to the insurance companies. + 10% Keeps management ... policies and procedures and maintains and exercises comprehensive knowledge of insurance company billing requirements and regulations to research and resolve unpaid… more
- Adecco US, Inc. (Utica, NY)
- …cases by overseeing benefit investigations, prior authorizations, claims escalations, and appeals , ensuring timely patient access. 3. Design and deliver advanced ... Experience in the healthcare industry including, but not limited to insurance verification, prior authorizations, and/or claim adjudication, physician's office or… more
- Humana (Albany, NY)
- …other Medical management organizations, hospitals/ Integrated Delivery Systems, health insurance , other healthcare providers, clinical group practice management. + ... review organization, such as Medicare Advantage, managed Medicaid, or Commercial health insurance . + Experience with national guidelines such as MCG(R) or InterQual… more
- Excelsior Orthopaedics Group (Amherst, NY)
- …Monitor and respond to coding-related denials, rejections, and edits; assist with appeals and identify areas for process improvement. + Collaborate with the billing ... benefits package that includes health (with employer contribution), dental, and vision insurance , employer paid base life, and other voluntary benefits*. Time off… more
- Health Advocates Network (Albany, NY)
- …Evaluate External Appeal applications for eligibility based on requirements in Insurance Law Article 49. Request necessary information from appropriate party and ... respond to questions about the process. Investigate complaints against regulated insurance companies, applying mandates in Insurance Law and provisions in the… more
- Rochester Regional Health (Rochester, NY)
- …coverage policies and/or phone calls to the payer. Submit corrected claims and appeals . + Process account adjustments and refunds as needed according to department ... and terms, and relevant HIPAA privacy rules and other regulations. Expertly use insurance websites to explore denial issues and resolve them using the tools in… more
- New York State Civil Service (Albany, NY)
- …responses to regulator audit questions; debriefings; bid protests and bid protest appeals ; draft and/or reviewing a full array of agreements which include data ... $118,000 - $171,000.- Excellent Benefit Package which includes: NYS health insurance , free dental and vision coverage, competitive retirement options, tuition… more
- New York State Civil Service (Albany, NY)
- …responses to regulator audit questions; debriefings; bid protests and bid protest appeals ; draft and/or reviewing a full array of agreements which include data ... $105,000 - $149,000.- Excellent Benefit Package which includes: NYS health insurance , free dental and vision coverage, competitive retirement options, tuition… more
- University of Rochester (Rochester, NY)
- …closure and obtain maximum revenue collection. Researches, corrects, resubmits claims, submits appeals and takes timely and routine action to resolve unpaid claims. ... to follow up on disputed, unpaid, underpaid, or overpaid insurance or contracted service accounts in order to bring...for in-person meetings and phone conferences with third party insurance representatives due to claim and system issues requiring… more
- New York State Civil Service (Albany, NY)
- …case law. The incumbent serves as the Chancellor's representative in hearing appeals of disciplinary and contract grievances pursuant to the collective bargaining ... is $90,000-$110,000.- Excellent Benefit Package which includes: NYS health insurance , free dental and vision coverage, competitive retirement options, tuition… more