- Cognizant (Albany, NY)
- …a High School Diploma or equivalent is required + A minimum of 1 years of medical claims processing is required + Facets experience is highly preferred + ... Claims Processors to join our growing team. The ** Medical ** ** Claims Processor** is responsible for the...Responsibilities** + Responsible for reviewing the data in the claim processing system (Facets) and comparing it… more
- CVS Health (Albany, NY)
- …information for claim or reconsideration. **Required Qualifications** + 2+ years of medical claim processing experience. + Previous experience in a ... multiple assignments competently, accurately and efficiently. **Preferred Qualifications** + Self funded medical claim processing experience. + DG system… more
- City of New York (New York, NY)
- …position include, but are not limited to the following: 1) Set up No-fault claim files which includes issuing and processing NF2 application, confirming the ... submission and, issuing verification letters to claimants and medical providers; 2) Review and disallow claims ...to gather information relevant to the investigation of the claim ; 13) Investigate, identify, and report fraudulent claims… more
- CVS Health (Albany, NY)
- …competently, accurately and efficiently. **Preferred Qualifications** - 18+ months of medical claim processing experience - Self-Funding experience ... or claims that exceed specialist adjudication authority or processing expertise. - Applies medical necessity guidelines, determines coverage, completes… more
- Axis (New York, NY)
- …determine coverage, liability, and settlement value. + Leading initiatives to enhance claims processing efficiency and accuracy within the team. + Collaborating ... Claims Specialist - Cyber, Media, and Crime Claims for its North America Claim Team....and directing the development of training materials relevant to claims processing . + Show a commitment to… more
- Albany Medical Center (Albany, NY)
- …school education or equivalent + 1-2 years of experience in medical billing or medical claims processing + Working knowledge in Excel and Word + Ability ... spirit in his/her team. Thank you for your interest in Albany Medical Center! Albany Medical is an equal opportunity employer. This role may require access to… more
- Sedgwick (Albany, NY)
- …Liability (MEDMAL) **PRIMARY PURPOSE** : To analyze complex or technically difficult medical malpractice claims ; to provide resolution of highly complex nature ... and RESPONSIBILITIES** + Analyzes and processes complex or technically difficult medical malpractice claims by investigating and gathering information to… more
- Molina Healthcare (Rochester, NY)
- …Contracted Provider disputes and appeals to ensure adherence with Molina claims processing standards and provider contractual agreements. Includes responsibility ... from start to finish of the claim disputes to include intake, processing , decisioning,...a manager role. * Experience reviewing all types of medical claims (eg CMS 1500, Outpatient/Inpatient, Universal… more
- Sedgwick (Albany, NY)
- … by investigating and gathering information to determine the exposure on the claim ; manages claims through well-developed action plans to an appropriate and ... including strategic vendor partnerships to reduce overall cost of claims for our clients. + Manages claim ...directions in a professional and timely manner. + Communicates claim activity and processing with the claimant… more
- Sedgwick (Albany, NY)
- … by investigating and gathering information to determine the exposure on the claim ; manages claims through well-developed action plans to an appropriate and ... including strategic vendor partnerships to reduce overall cost of claims for our clients. + Manages claim ...directions in a professional and timely manner. + Communicates claim activity and processing with the claimant… more
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