- Community Medical and Dental Care Inc (Monsey, NY)
- …appropriate records relating to all professional services rendered. + Prepare and review reports, claims , and correspondences. Ensure that records and ... Co mmunity Medical & Dental Care, Inc., is a non-profit...and culturally sensitive health care to our patients. Community Medical & Dental Care, Inc., has over 60 healthcare… more
- FlexStaff (Chappaqua, NY)
- …coding - Audit anesthesia records focusing on quality, completeness, and correctness of claims based on services provided - Communicate review findings clearly ... clinical records, ensuring accuracy, completeness, and compliance. Your expertise with medical terminology, coding, and documentation will support our mission to… more
- SUNY Upstate Medical University (Syracuse, NY)
- …work queue. Serves as a resource to patients, staff, and medical providers for prior authorizations. PRINCIPAL DUTIES AND RESPONSIBILITIES: Under general ... Assists clinics and patients with understanding prior authorizations and their medical (and possibly the pharmacy) benefits as required. Educates patients and… more
- AON (NY)
- …all service-related calls to assigned service person + Stay informed of all claims or service issues and become involved in resolution when required + Participate ... the community + Keep informed of industry developments through review of trade press and by attending insurance carrier...to detail + Advocate for insured with underwriting and claims + Ability to demonstrate a positive attitude and… more
- Stony Brook University (East Setauket, NY)
- …but are not limited to:** + Develops staff work listing logic/strategy and claims resolution work flows. + Educates and trains new staff regarding departmental and ... in Joint Operating Calls (JOC) with insurance payers. + Monitors medical record request, correspondence distribution and scanning processes, volume, and trends.… more
- Kelly Services (Rochester, NY)
- …directed + Issue verbal and written notifications to members as required + Review and interpret prescription and medical benefit coverage (including Medicare D); ... Description** The Pharmacy Prior Authorization Technician performs initial-level processing and review of prior authorization requests for both pharmacy and … more
- Elevance Health (Latham, NY)
- …experience preferred. + Broad knowledge of clinical documentation improvement guidelines, medical claims billing and payment systems, provider billing ... the conditions and DRGs billed and reimbursed. Specializes in review of Diagnosis Related Group (DRG) paid claims...you will make an impact:** + Analyzes and audits claims by integrating medical chart coding principles,… more
- New York State Civil Service (New York, NY)
- …and resolve underwriting issues.* Analyze previous loss experience and premium data.* Review /analyze experience rating data and claims material to price a ... policy.* Define, restrict, or qualify policy coverage.* Review payroll audits and policy renewals.* Represent NYSIF at Hearings before the Workers' Compensation… more
- AON (New York, NY)
- …the effective date, and responding to client requests and inquiries. + Review completed applications and underwriting submission materials prepared by Assistant Vice ... check market quotes, binders and policy documentation. + Ensure client, marketing and claims files are maintained in a timely fashion. + Check computations of… more
- City of New York (New York, NY)
- …requests from MCO to obtain prior authorization approvals and claim reimbursement. - Review all claims CPT/ICD-10/HCPCS, payment modifiers in billing software to ... perform health insurance billing activities and support functions including claim review , claim submission, follow up and collection activities. Applicants must be… more