• Utilization Manager Reviewer, RN (Multiple…

    Excellus BlueCross BlueShield (Rochester, NY)
    …and Federal Mandates. + May be responsible for pricing, coding, researching claims to ensure accurate application of contract benefits and Corporate Medical ... the total rewards package may include participation in group health and/or dental insurance , retirement plan, wellness program, paid time away from work, and paid… more
    Excellus BlueCross BlueShield (08/23/25)
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  • Revenue Cycle Coordinator IV - Remote/Hybrid…

    University of Rochester (Rochester, NY)
    …payment. Makes independent decisions as to the processes necessary to collect denied insurance claims and resolve billing issues. Must track payer/billing issues ... third-party payers to obtain payments, research, and resubmit rejected claims to primary payers, obtain and verify insurance...refund of credits + Review and advise supervisor or manager on trends of incorrectly paid claims more
    University of Rochester (08/07/25)
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  • Clm Resltion Rep III, Hosp/Prv

    University of Rochester (Rochester, NY)
    …will make independent decisions as to the processes necessary to collect denied insurance claims , no response accounts, and will investigate resolving billing ... as well as contact payer representatives to research/resubmit rejected claims to obtain and verify insurance coverage.... refund credits. + Review and advise supervisor or manager of trends on incorrectly paid claims more
    University of Rochester (08/07/25)
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  • Medical Services Coordination Specialist I/II/III

    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 ... clinical staff. + Navigates and utilizes corporate applications; core claims and membership system, intranet and related links to...assigned to non-care managers are monitored by the care manager + The care manager provides feedback… more
    Excellus BlueCross BlueShield (08/27/25)
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  • Product Development Manger

    Philadelphia Insurance Companies (Melville, NY)
    …Philadelphia Insurance Companies, Tokio Marine America, Inc., TMNA Services, LLC, TM Claims Service, Inc. and First Insurance Company of Hawaii, Ltd.) is an ... Description Marketing Statement: Philadelphia Insurance Companies, a member of the Tokio Marine...AM Best. We are looking for a Product Development Manager to join our team. Summary The Product Development… more
    Philadelphia Insurance Companies (06/26/25)
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  • Director - Corp Insurance Sr Group Mgr.…

    Citigroup (Queens, NY)
    …and administration of property/casualty insurance programs and management of captive insurance company + Execute insurance claims management, oversight ... Senior manager within Citi's Corporate Insurance and...medical, dental & vision coverage; 401(k); life, accident, and disability insurance ; and wellness programs. Citi also… more
    Citigroup (09/04/25)
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  • Clm Resltion Rep III, Hosp/Prv

    University of Rochester (Albany, NY)
    …(EOBs), insurance correspondence, rejections received thru daily electronic and claims submission, etc. Research claims , identify problems, and take ... individual, and internal equity considerations._ **Responsibilities:** GENERAL PURPOSE The Claims Resolution Representative III is responsible for working across the… more
    University of Rochester (08/07/25)
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  • Clm Resltion Rep IV, Hosp/Prv

    University of Rochester (Rochester, NY)
    …up on 'non-routine' denied accounts through review of remittances (EOBs), insurance correspondence, rejections received thru daily electronic claims submission, ... through telephone calls, payer website, and in written communication Mails paper claims with appropriate attachments when needed ( insurance EOB, medical records,… more
    University of Rochester (08/07/25)
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  • Procedural Billing Specialist I - Surgery

    Mount Sinai Health System (New York, NY)
    …Receivable, Charge Entry, Edits and Payment Posting. This individual facilitates claims processing and payments services rendered by physicians and assists with ... analysis and problem resolution to ensure accurate and timely payment of claims and collection. The Specialist works directly with the Department Administrator.… more
    Mount Sinai Health System (08/29/25)
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  • Benefits and Leave Adminstrator

    University of Buffalo - Campus, Dining (Buffalo, NY)
    …ensures proper procedures and policies are followed related to the processing of disability , FMLA, PFL and workers' compensation claims , leave requests, and ADA ... Resource Benefits and Leave Administrator Reports to Benefits and Leave Manager /Human Resource Director Department Human Resources FLSA Status Full-Time, Exempt… more
    University of Buffalo - Campus, Dining (08/22/25)
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