• Medical Director - Medicaid N. Central

    Humana (Albany, NY)
    …duties include, but may not be limited to, an overview of coding practices and clinical documentation, grievance and appeals processes (including pharmacy), and ... other Medical management organizations, hospitals/ Integrated Delivery Systems, health insurance , other healthcare providers, clinical group practice management. +… more
    Humana (05/14/25)
    - Related Jobs
  • Clm Resltion Rep III, Hosp/Prv

    University of Rochester (Albany, NY)
    …policies and procedures and maintains and exercises comprehensive knowledge of insurance company billing requirements and regulations to research and resolve unpaid ... Follows up on multi-faceted denials through review of remittances (EOBs), insurance correspondence, rejections received thru daily electronic and claims submission,… more
    University of Rochester (05/13/25)
    - Related Jobs
  • Outpatient Administrative Specialist

    SUNY Upstate Medical University (Syracuse, NY)
    …Summary: The Outpatient Administrative Specialist will assist with patient registration, insurance verification, appointment check in and check out, and appointment ... Minimum Qualifications: Associate's degree and two (2) years relevant patient financial/ insurance services experience in a healthcare related setting or equivalent… more
    SUNY Upstate Medical University (05/12/25)
    - Related Jobs
  • Environmental Claims Specialist

    Sedgwick (Buffalo, NY)
    …Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Environmental Claims Specialist **Job Description Summary** To analyze complex or ... claims and legal actions. + Analyzes applicable complex liability insurance coverage and policies + Negotiates claim settlement up...+ Ensures claim files are properly documented and claims coding is correct. + Refers cases as appropriate to… more
    Sedgwick (04/29/25)
    - Related Jobs
  • Clerical Specialist II

    SUNY Upstate Medical University (Syracuse, NY)
    …are needed and obtain necessary supportive information. Obtain appropriate insurance authorizations when needed. Obtain additional records, reports, radiological ... reports, etc. as requested by patient, providers, or staff. Verify insurance coverage and requirements, forward to appropriate staff, and discuss with patients.… more
    SUNY Upstate Medical University (04/29/25)
    - Related Jobs
  • Medical Director - Care Plus - Florida

    Humana (Albany, NY)
    …require conflict resolution skills. Some roles include an overview of coding practices and clinical documentation, grievance and appeals processes, and outpatient ... other Medical management organizations, hospitals/ Integrated Delivery Systems, health insurance , other healthcare providers, clinical group practice management. +… more
    Humana (04/24/25)
    - Related Jobs
  • Outpatient Administrative Specialist-Verona Cancer…

    SUNY Upstate Medical University (Syracuse, NY)
    …check-in and check-out procedures such as entering and verifying demographic, insurance and financial information and generating routine forms and other ... assist with other Front Desk tasks. Works with/advises patients on insurance carrier requirements including services not covered and obtains documentation.… more
    SUNY Upstate Medical University (04/16/25)
    - Related Jobs
  • Biller - A/R - Full Time - Days

    Mohawk Valley Health System (Utica, NY)
    …stability within the Hospital. Experience in billing Medicare, Medicaid, Commercial Insurance , HMOs, and Worker's Comp/No Fault is required. Knowledge in ICD-9, ... ICD-10, HCPCS coding and medical terminology is a plus. Core Job...Job Responsibilities + Promotes a professional working relationship with insurance companies. Knows each payor representative and uses them… more
    Mohawk Valley Health System (04/15/25)
    - Related Jobs
  • Patient Registration Associate

    Highland Hospital (Penfield, NY)
    …and procedures using hospital scheduling system; collecting demographic information; insurance verification and pre-verification; referring to financial counselor as ... needed; collecting co-payments; recording all copayment collections by individual insurance codes, reconciling at the end of the day; obtaining referrals as needed;… more
    Highland Hospital (04/09/25)
    - Related Jobs
  • Claims Resolution Representative

    University of Rochester (Rochester, NY)
    …policies and procedures and maintains and exercises thorough knowledge of insurance company billing requirements and regulations to research and resolve unpaid ... Follows up on denied accounts through review of remittances (EOBs), insurance correspondence, rejections received thru daily electronic and claims submission, etc.… more
    University of Rochester (03/17/25)
    - Related Jobs