- Adecco US, Inc. (New York, NY)
- …on-site or virtual training and education to healthcare providers and staff on reimbursement processes, including lunch-and-learns and scheduled presentations. Log ... Support (20%)** - Assist offices with claims, billing and coding, appeals , medical benefit interpretation, and co-pay or patient assistance programs. Coordinate… more
- University of Rochester (Rochester, NY)
- …orders and sends them for review and approval. Anticipates needs of insurance companies by gathering all necessary information for referrals and prior ... edits and obtains signatures for non-routine letters of correspondence related to appeals on denied claims, including compiling all necessary information and drafts… more
- Touro University (New York, NY)
- …credits, monitors the progress of majors, and responds to student appeals appropriately + Coordinates and supervises student learning assessment activities within ... Plan + Dependent Care and Transit Programs + Life Insurance , AD&D and Voluntary Supplemental Life Insurance ...an international institution with diverse and talented faculty and staff , we value an inclusive learning experience where students… more
- New York State Civil Service (Albany, NY)
- …applications.Civil Investigations: Works on investigations of potential violations of the Insurance , Banking, Financial Services, and other state and federal laws, ... with and serves as a primary resource for the Department's leadership and staff in ensuring that its priorities, policies, and communications take into account… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …matter expert and occasionally works directly with the operation and clinical staff to resolve issues and escalated problems. + Consistently demonstrates high ... not limited to UM and CM, Fair Hearings and Appeals /Grievances, within three months of working in position. +...package may include participation in group health and/or dental insurance , retirement plan, wellness program, paid time away from… more
- Rochester Regional Health (Rochester, NY)
- …the medical management department in the tracking, trending and reporting of appeals and charge recovery information. + Conducts reviews of cost outliers and ... and procedures. + Screen patients at risk with no, or inadequate health insurance coverage for immediate and chronic needs. + Implements plan to facilitate… more
- Elevance Health (Latham, NY)
- …Associate Medical Director** is responsible for supporting the medical management staff ensuring timely and consistent medical decisions to members and providers. ... for services requested. + Makes medical necessity determinations for grievance and appeals appropriate for their specialty. + Ensures consistent use of medical… more
- University of Rochester (Rochester, NY)
- …follow-up to obtain maximum revenue collection. Researches, corrects, resubmits claims, submits appeals and takes timely and routine action to resolve unpaid claims. ... + May establish financial arrangements for charges. + Processes commercial insurance claims when applicable. + Refers to collectors for payment arrangements,… more
- Elevance Health (New York, NY)
- …alternative surgical and non-surgical treatments. + Performs first level provider appeals of coverage decisions. + Provides support and education to internal ... clinical and non-clinical staff regarding the principles associated with appropriate musculoskeletal diagnoses, treatments, and management. + Participates in… more
- Robert Half Legal (Rochester, NY)
- …spanning from initial case evaluation to trial proceedings and potential appeals . + Perform comprehensive legal research and prepare litigation documents, including ... career as an attorney. + Effectively collaborates with other attorneys and staff members in team environments. + Possesses strong organizational, time management,… more