- Excellus BlueCross BlueShield (Rochester, NY)
- …Medicaid, CPT, HCPCS, ICD10, DRG, APC, RBRVS, etc.). + Extensive experience with claims processing systems, claims flow, adjudication process, system edits ... case planning and research, conducting onsite or desk audits, clinical reviews of medical records to ensure correct billing of services and appropriateness of care,… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …. Ensures accurate payment by independently utilizing DRG grouper, encoder, and claims processing platform. . Manages case volumes and review/audit schedules, ... 10CM, MS-DRG, and APR-DRG with a broad knowledge of medical claims billing/payment systems, provider billing guidelines,.... Intermediate knowledge of PC, software, auditing tools and claims processing systems. Level II (in addition… more
- Otsuka America Pharmaceutical Inc. (Albany, NY)
- …to create a unified view of stakeholder interactions. + Apply natural language processing (NLP) to extract insights from unstructured medical texts, such as ... that drives us to uncover answers to complex, underserved medical needs, so that patients can push past the...Management** + Explore and analyze common pharmaceuticals data (eg, claims ) as well as novel data sets based on… more
- FLACRA (Newark, NY)
- …FLACRA's billing and payment collection processes. This position is responsible for processing claims , managing accounts receivable, and ensuring timely and ... Accounting: Accounts Receivable, Medical Biller FLACRA Newark, NY (Onsite) Full-Time $20.00...balances. + Work with insurance companies to address disputed claims and resolve processing issues. + Maintain… more
- Mount Sinai Health System (New York, NY)
- …processes, and related regulations. ? Familiarity with contract terms, NYS regulations, claims processing , and healthcare reimbursement models. ? Experience in ... to ensure proper interpretation and application of terms during claims processing . * Ensure that all contract...Sinai Health System is one of the largest academic medical systems in the New York metro area, with… more
- Molina Healthcare (Albany, NY)
- …concisely, accurately and in accordance with regulatory requirements. * Researches claims processing guidelines, provider contracts, fee schedules and systems ... or equivalent combination of relevant education and experience. * Health claims processing experience, including coordination of benefits (COB), subrogation… more
- Access: Supports For Living (Middletown, NY)
- …identified revenue cycle billing issues + Handling billing cycle review procedures for pre- processing (scrubbing) of weekly claims processing + Analyze, ... billing and processing program claims for accuracy and completeness; submit claims ...well as on a collaborative team. + Knowledge of Medical Insurance programs such as Medicaid, Medicare and Dual… more
- Robert Half Accountemps (Rochester, NY)
- …Summary: The Medical Billing Specialist is responsible for accurately processing and managing healthcare billing information for medical practices, clinics, ... regulations. Requirements Key Responsibilities: + Review, verify, and process medical billing data for insurance claims and...and process medical billing data for insurance claims and patient invoices, ensuring all information is accurate… more
- UHS (Binghamton, NY)
- …Administrative Secretary on a monthly basis + Tracks and assists with documentation and claims processing for Medicare and Workers' Compensation claims to ... ensure reimbursement of rehab services. + Assists HIM in processing medical record requests and ensures authorization to release patient information + Collects… more
- Sedgwick (Albany, NY)
- …containment techniques including strategic vendor partnerships to reduce overall cost of claims for our clients. + Communicates claim action/ processing with ... claimant, client, state agency, managed care organization and appropriate medical contact. + Ensures claims files are properly documented and claims coding… more