- Cognizant (Albany, NY)
- …and able to multi-task successfully? If so, please apply today! The Claims Processor, you will ensure accurate and timely adjudication of professional and ... hospital claims utilizing payer specific policies and procedures. Provide support...UB or HCFA paper or EDI information. + Evaluate medical records to determine if the service rendered was… more
- Sedgwick (Syracuse, NY)
- …is correct. + May process routine payments and prescriptions and status reports for lifetime medical claims and/or defined period medical claims . + ... and industry best practices. **ESSENTIAL RESPONSIBILITIES MAY INCLUDE:** + Adjusts medical -only claims and minor lost-time workers compensation claims… more
- Sedgwick (Albany, NY)
- …properly documented and claims coding is correct. + May process complex lifetime medical and/or defined period medical claims which include state and ... Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Adjuster I Workers Compensation I CA experience required I Hybrid **PRIMARY… more
- MVP Health Care (Rochester, NY)
- …innovative thinking and continuous improvement. To achieve this, we're looking for a Medical Claims Examiner to join #TeamMVP. This is the opportunity for ... + Knowledge of CPT, HCPCS, ICD-9-CM coding systems and Medical terminology preferred. + Strong PC skills required, Microsoft...responsibilities:** + Using a PC /Microsoft Window environment, adjudicates claims with the aid of the Facets and Macess… more
- Molina Healthcare (Rochester, NY)
- …including 2 years in a manager role. * Experience reviewing all types of medical claims (eg CMS 1500, Outpatient/Inpatient, Universal Claims , Surgery, ... Provider disputes and appeals to ensure adherence with Molina claims processing standards and provider contractual agreements. Includes responsibility from… 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
- KPH Healthcare Services, Inc. (Syracuse, NY)
- …Summary:** Responsible for developing, improving and continuing the process billing of medical claims for specialty pharmacy facilities. Needs to communicate ... assigned tasks. Establish, manage, and communicate the process of billing medical claims for specialty facilities. **Responsibilities** **Job Duties:** +… more
- University of Rochester (Rochester, NY)
- …assigned. Qualifications: - Required: Associates Degree and 4-5 years of professional medical claims billing and collecting experience; or equivalent combination ... paper claims with appropriate attachments when needed (insurance EOB, medical records, etc.). Ensures additional documentation and/or information is provided for… more
- CVS Health (Albany, NY)
- …improve member satisfaction and retention by providing accurate and timely resolution in processing medical claims . You will be a key link in providing our ... do it all with heart, each and every day. Reviews and adjudicates claims in accordance with claim processing guidelines. Claim Benefit Specialists have the… more
- CVS Health (Albany, NY)
- …of managed care and how provider reimbursement policies relate to the control of medical claims costs. * Full comprehension of provider contracts and the ... with a passion for healthcare economics? Join our team as a **Manager, Medical Economics** and play a pivotal role in shaping cost-effective healthcare strategies.… more